Previously on Code Blue.
There's no room for mistakes on Doctor Heli.
With limited equipment and a limited amount of time, you have to save a dying patient.
You are all rivals.
Stay away from those who have no ability and skill.
Dr. Mitsui!
I can't do it.
There is a considerable amount of hemorrhaging coming from the placental abruption.
The fetal heart rate has reached 80bpm...
I understand.
Be quiet already.
Making a mistake or wavering while on location,
can change the patient's life.
Understanding your own limits,
as opposed to improving your abilities, is more important.
Amputation, right?
Amputation? On location?
He's 19, right?
When you performed the amputation...
Did you feel anything?
It was exciting.
Faster than anyone else...
I... will become an excellent doctor.
Aizawa-san, what about your parents?
They passed away.
I was brought up by my grandmother.
Your grandmother has been hospitalized.
Grandma?
Pleased to meet you.
It is dementia, after all?
You stole it, didn't you? My money!
Give it back!
My grandma
would always put herself last.
For my sake, she would sacrifice her life.
I don't think that's the case.
I think she's happy to do something for you.
I promised Kosaku
that I'd buy him a lot of sweets.
He is
doing his best on his own.
Grandma...
 田 We believe there are critically injured people from the blast. 田
I'll head over there.
Let's do it in one go.
Support the body.
Yes.
1, 2, 3!
There's still work left for you to do.
You'll tell your child's name on your own.
You can leave now.
You can...
It's okay.
To me...
I have no other place to be.
I was thanked...
...by a patient I wasn't able to save.
You're a doctor, right?
Then, well...
Isn't that inevitable?
I am the worst.
Even from my own boyfriend's life... I ran away.
Someone like me...
I wonder if it's okay for me to be riding the helicopter.
I also...
...care about myself the most.
Rather than tending to my grandma,
I'd enter the operation rooms
and want to go on the helicopter.
After all, I, also...
...believe I am the most important.
There are times when I'm uncertain, though,
of what the most important thing is.
How are the Fellowship members?
How about letting them ride the helicopter on their own?
Can I ask you one thing?
Why did you pick me again to be the instructor for this year?
Because... You hate young people.
Isn't that right, Dr. Kuroda?
Which way is it?
Wait, Shiraishi!
Shiraishi!
It's because I came in here in such a hurry...
Cut it, Aizawa...
Understood.
Don't you feel that you've torn apart his skill as a surgeon?
If only...
...I had never met you all.
I've ruined Dr. Kuroda's life!
I shouldn't have come here!
That is... my son.
It seems he divorced when his son was 18 months old.
He most likely doesn't even remember his son's face anymore.
A brain tumor?
It's in a difficult area. I can't guarantee anything.
Cure him, Dear!
You sacrificed everything to better your abilities, didn't you?
Your family?
Just my mother and me.
Are you going to come back to Japan?
Are you okay? Just the two of you.
Even concerning your arm
if it had been my old self,
it would have been simply just another treatment.
Right now...
I can't look you in the eyes.
Doctor.
What does it mean to be an excellent doctor?
The answer to that
can probably be found while on location only.
Multiple collisions on a highway.
Casualties unknown.
I guess that means we have no choice but to do it.
Dr. Aizawa!
I can't tell the degree of hemorrhaging. Add more RCC units, please!
There aren't any more.
Pump in albumin instead.
Please allow me to go.
It's horrible on location!
I know!
Doctors, take shelter, please.
Gasoline is leaking from the truck.
Please evacuate until we can confirm safety.
Go bring them back.
Don't let anyone die!
After the safety check is done, by the time we come back here...
Will there be anything left for us to do?
How much longer till rescue?
We're looking at ten minutes.
Prepare a stretcher.
Okay.
Let's try for another ten minutes.
We'll evacuate immediately once rescue is over.
Okay.
If a second disaster had struck, what would have happened?
Whether an accident or disaster, a doctor will go.
That Doctor Heli doesn't avoid danger is also a fact.
Shouldn't a punishment be imposed on the Fellowship?
What is necessary for them is not a punishment but re-training, is it not?
The first experience of separation in my life
was the parting of my parents.
As my father was leaving the house
he gave me a final pat on the head.
I remember wondering why he pat me
as I had found it strange.
Separation is an indispensable part of life.
Unrequited love.
Parting with friends.
And also, death.
Though separation can be foretold,
it can also be sudden.
The conclusion to encounters
is without fail, separation.
 田  田 7 hours earlier
Screen: Flight Doctor Cadet Orientation
Lecturer: Shoyo University Hokubu Hospital Emergency Lifesaving Center, Dr. Morimoto Tadashi
When a human falls into cardiac arrest,
and oxygen isn't sent to the brain within 10 minutes,
it will lead to death.
The longer the amount of time after cardiac arrest,
even if it suspends one's life, the brain is heavily damaged.
When one bears a serious external injury, it is essential that
a conclusive treatment be performed within one hour.
For that reason, skilled doctors
are sent to the location with the needed equipment to conduct treatment.
This is Shohoku Doctor Heli. We have just taken off.
Currently heading toward Kashiwa.
Estimated arrival in... eight minutes.
This is Shohoku Doctor Heli. The patient information, please.
The doctor's ultimate delivery system.
That is... Doctor Heli.
Hey!
What did you do the past week?
Yourself?
Me? I went back home.
I got fatter.
Look.
Around this area also.
You're too close.
Acting cool, as usual, Kosaku-chan.
And you're as annoying as ever.
The rendezvous point is North Kashiwa Elementary School's oval.
The ambulance is already on location.
Roger.
Patient information.
64 year old, male.
Collapsed due to pain in the chest.
The electrocardiogram monitor shows that ST is climbing.
ST - a segment which measures the depolarization of a ventricle
After the acceptance of a request, take-off is achieved in an average of 3 minutes.
Aboard the helicopter, patient information is received while heading to the location.
You're cramming it all in, as usual.
Morning.
Morning.
Say, everyone took a proper holiday this past week, right?
What do you mean?
No one slipped in and handled some appetizing cases, right?
I did, an operation on a main artery injury.
You're kidding, right?
Yeah, I am.
Listen, when you're telling a joke, could you change your facial expression?
I can't tell otherwise.
What did you do?
I went back home. I'm sick of it already.
How come?
Because I seldom go back there,
my father thinks it's about time and has a bunch of marriage-interview photos.
Was there anyone good?
Why would I even look?
But anyway, he thinks that marrying into a good house is his daughter's greatest happiness.
It's impossible.
If that's the case though,
a salary cut would be better, like Dr. Mitsui.
Doctor, this way!
Reaching the location, they join the ambulance team
and give treatment there.
Regarding Kuramoto-san in HCU,
he has restricted visiting hours, so please keep that in mind.
Yes.
Will his family be okay with that?
Good morning.
I look forward to working with you all again.
Morning.
Good morning.
Well, I'm counting on you all.
Yes, understood.
Could you take care of Kobayashi-san's position changes?
Yes!
In an acute myocardial infarction, with a slow pulse.
Let's conduct external pacing.
Dr. Mitsui.
Yes.
Both Fushimi East Hospital and Kitano National Hospital are OK for acceptance.
How long does it take?
15 minutes for Fushimi East, 18 minutes for Kitano.
They're both quite far.
Blood pressure falling.
Prepare the pacing pad, and also for intubation.
Okay.
Pulse is in the 30bpm range.
He won't make it.
What's your decision?
If it's our base, it's around ten minutes, right?
Transport him back to base.
I see, because it's today.
Yes.
We've returned, to the battlefield.
Yeah.
It's starting again.
Yes.
In a state of AMI, with a slow pulse.
Heart rate has recovered from 35bpm to the 70's with pacing.
Saturation has dropped to 86.
How much longer?
Four minutes.
He won't make it. We'll intubate. 8.0 tube.
Prepare the echo and contact the Cardiac Catheterization Room.
And also a balloon pump?
Yes, please.
Okay.
Prepare the A-line.
Yes.
This is Lifesaving.
Please prepare a balloon pump.
At night the helicopter is not in operation.
During the day, when acceptance to another hospital is ready, a second request can be accepted.
And that's the outline of Doctor Heli.
Are there any questions?
Here.
Yes?
At Shohoku Lifesaving Center, how many are currently in the Fellow?
Four doctors.
Currently, what are their main duties?
Currently, they are in penitence.
Penitence?
Yes...
That tunnel incident the other day, you probably saw it on the news.
There, they did something totally rash.
We were at a loss.
At that moment, they had put a big burden on us.
Though, they're reinstated as of today.
Okay, the next question.
So they're back.
Those troublemakers.
 田 CODE BLUE
1, 2, 3!
Use pacing on his slow pulse.
We'll take him to the pacing catheter immediately.
In the case of AMI coupled with a slow pulse, thinking about it...
Physical changes in the right coronary artery.
That'd be a lower stomach wall infarction.
Heart failure in the right side and slow pulse rates are characteristic of it.
You're going to feel a slight prick.
Heart lead connected.
I'll start the cardiac echo.
The power hasn't been connected yet.
Then, I'll take 12-lead ECG.
I can't get a blood pressure reading.
Administer nicorandil through a syringe pump.
Okay.
He has VF. Starting defibrillation.
Charge at 150J.
Yes.
Prepare epinephrine for injection.
Yes.
They're at it.
Charging complete.
Everyone step back.
25, 26, 27, 28, 29, 30!
Regained heart rate.
Blood pressure, 90/50. Saturation at 100.
We'll have to rule out thoracic aortic dissection.
If there's time after the heart catheter, take a CT scan of the chest.
X-ray Room and Catheter Room have been contacted.
Hey.
Where's Dr. Kuroda?
Dr. Kuroda.
In the end, you're not going to continue working for me?
Just that, the Fellowship members...
There's still much more that they can learn from you.
This place is for saving lives.
A doctor that can't even intubate shouldn't be here.
I'd like to give rehabilitation a go.
Once again, until I become worn-out.
Though, there's no telling how much I'll recover.
I see.
It's the same as that day...
When you invited me to come to Shohoku,
and I saw Doctor Heli for the first time.
At the shabby heliport,
there stood a single, small helicopter only.
Indeed.
Once again, I'd like to start afresh.
Chief...
Yes?
I'll never forget
what happened that day for the rest of my life.
Thank you for all your guidance.
Are you sure about leaving without saying anything to the Fellowship?
It's not like I have anything to say to them.
Dr. Kuroda.
Did you start... liking those youths?
He quit?
He already left, I heard.
And apparently he said farewell to Dr. Morimoto and Dr. Mitsui.
Without saying a word to us?
What's with that?
Is it okay to just leave like that?
Is that even a farewell?
I guess it means there was no need to see us.
After what he's been through...
It makes you feel lonely.
Yeah.
Yes.
As a university hospital,
we can't keep patients in stable conditions here forever, unfortunately.
I understand.
Since she started practicing to walk, Kinue-san has mentally calmed down considerably.
She's become quite motivated.
Yes.
Kinue-san's care manager seems to have come to the hospital.
You can consult them with what you plan to do.
See you.
Hello?
Yes.
What?
Does she really have it?
It's possible.
There are cases where delirium occurs due to pain from bone fractures,
and upon complete recovery, their consciousness is restored.
Also, conversely, it's possible that the dementia may progress.
However, it's best to be certain that she's headed in the positive direction.
Grandma...
Kosaku...
Aren't you in the middle of work?
Is it okay?
Grandma...
I've heard everything.
I've really... been a handful, haven't I?
This uniform is wonderful.
It really suits you well, Kosaku.
Thank you...
...for the hat.
Seriously?
I went by to greet her and she's already feeling well.
Completely sound and steady.
Really? That's great!
Yes.
Well, I guess I should go make an appearance later, also.
What's wrong?
Okay.
Kinoshita-san in 2B?
Understood. I'll be there right away.
Grandma.
Hurry up and go.
It's no good for you to be chatting here.
Once I have some time, I'll come by again.
I see, she's being discharged soon.
Yeah, she's back to her former self,
but she still needs rehabilitation for her legs.
Living alone would be quite difficult.
I wonder if she'll live together with Aizawa.
But with so many cases here, Kinue-san would need to take care of herself.
So that means...
...that she'll go to some institution?
B-but, well, whatever happens, it's a good thing that she's back to normal.
Yeah.
Today, do you want to go for lunch?
Ah, no thanks.
N-no, I mean with everyone.
Since our penitence is finally over with and everyone's here.
And we should probably help Aizawa think about what to do.
Well, if that's the case...
Sounds good.
I'll go.
Say...
Do you find me that annoying?
Yes.
Okay, that's fine. We'll start you on meals tomorrow.
Thank you.
Shall we cease the intravenous drip?
Doctor?
Yes, please.
Okay.
Noda-san, the intravenous drip will be removed when empty.
Good work.
Thanks.
Did you hear about Dr. Aizawa?
Yeah, it's a relief.
Is something wrong?
Kuroda.
Is that even a farewell?
Doing such a thing when we've worked together for months.
And still...
Hey.
Yeah?
Isn't this an unusual lesion appearing on the patient?
You're right!
Isn't that endocarditis?
endocarditis - inflammation of the inner layer of the heart
I wonder if it was checked in a blood culture or cardiac echo.
He has a fever.
 田 Heart Sugery Department
 田 Konno, Ryohei
 田 Admitted: 2008 September 11
 田 Dr. Hiratsu
Excuse me, are you part of the Heart Surgery Department's Fellowship?
What is it?
Under what authority are you to meddle with another department's affairs?
It doesn't matter what department I'm from.
He has a lesion breaking out all over his body.
As a precaution, I'm just telling you that it's better to do a blood culture and a cardiac echo.
I don't believe it's a problem. It's not much of a fever either.
He's been taking anticoagulation medicine, so it's because of that...
You better do it!
Hey...
You people are from the Lifesaving Fellowship, aren't you?
Famous for creating a bunch of problems.
What?
Could you stop complaining so much?
Complaining? I'm not complaining here!
Take it to the senior doctors.
In any case, the one you should be worried about is the patient.
Do the cardiac echo immediately!
What's this?
Don't tell me... There's a problem already?
Dr. Hiyama!
At times like that, please come tell me.
And I will talk to them.
It wasn't that bad. I was just...
You should not say these things to a Fellowship member directly.
You should have told a senior doctor,
or even to me, to tell a senior doctor.
That is what you call a 'hierarchy'.
Everybody, to some extent
is scared of giving a diagnosis.
If you approach that girl too directly, she'll lose her confidence.
But still...
Please, Dr. Hiyama.
They're back to it without delay.
I wonder if we can manage all that now that Dr. Kuroda is gone.
How is he?
Was it Konno-san? That patient earlier.
Yeah...
It was endocarditis.
In an emergency operation, he had a valve substitution.
I knew it. And yet she said all that.
She was angry and then felt dejected.
Why? Is she some newly hired office lady?
I sort of understand her feelings, though.
Everyone's too spoiled.
Even the chief, he said this and that about hierarchy,
but we're not mere company employees.
I guess...
Surgeons...
...are solitary.
Also, if you can't handle it, it's just better to quit now.
What's wrong? Did something happen?
H-hey! By the way...
Today, how about eating together as a group?
It's good once in a while.
Pass!
I have a heap of work to do.
What's with her?
Are you going?
Grandma.
This person is Ochiai-san, a manager who has been assisting me for a long time now.
This is my grandchild, Kosaku.
Hello, Doctor.
Just now, I was talking with Ochiai-san.
It seems some rooms are vacant at this home I had applied for.
We received her application around a year ago.
So I came to ask her if she still wants this.
There are quite a few good places which are moderately priced.
It's perfect.
I've recovered.
And I have to leave here, also, don't I?
Well...
That's true.
You can see the ocean. It's such a lovely place.
So, when would be a good time to move in?
You can move in whenever you wish to.
Really?
Yes.
Then...
I heard about Kinue-san.
Aren't you glad?
Yeah.
Has she completely recovered?
I'm surprised.
She's already decided where she's going to live after she gets discharged.
Really?
She's always been like that.
Is something wrong?
I wanted us to live together.
What?
I've neglected her for the longest time,
but I wonder why I think that now.
That's great.
I think Kinue-san will be delighted.
Yes.
That's nice.
A railroad accident? Do you mean that the train has hit something?
 田 No. A train on the Shin-Chiba rail line capsized after derailing. 田
 田 There's no detailed information yet. 田
 田 However, there were many passengers on board the train. 田
Derailed?
Roger that.
A helicopter will be deployed.
Please chase up further information.
Aizawa, Shiraishi, get ready.
Yes!
Confirm whether any hospitals in the Kisarazu South district can be prepared for urgent large-scale acceptance.
Okay.
We'll need an emergency setup.
Also, get confirmation on which hospital can be used as a base.
Understood.
Dr. Mitsui. We need a suitable strategy for the injured.
There are many large hospitals in that area.
Keep patient transportation to our hospital to a minimum.
For now, let's send all the doctors there by piston.
Got it.
Okay, priority on the triages.
Doctor Heli, engine start.
 田 Special Safeguarded Retirement Home Seiun no Sato
 田 Applicant's Name
Kinue-san?
Are you unsure? We can stop the application.
It's fine, I'm sure.
Really?
Ambulances and fire trucks have arrived on location.
There's a lot of confusion on location, but patients with red triage tags
 田 will be given priority on Shohoku Doctor Heli to be transported to the nearest hospital.
 田 This has been transmitted to the fire department. 田
Has the first-aid station been set up?
 田 Yes. 田
Roger that.
Shiraishi, you're in charge of the first-aid station.
Take care of the transport triages.
Me?
I'm counting on you.
Okay.
We'll confirm safety on the toppled carriages.
Give instructions to Hiyama and Fujikawa who'll be coming shortly.
Understood.
Try not to get yourself hurt out there, okay?
Yes!
Yes!
 田 Kisarazu South Pump 1, calling Shohoku Doctor Heli. 田
 田 A countless number of passengers are taking refuge. 田
 田 Take caution when landing. 田
Shohoku Doctor Heli, calling Kisarazu South Pump 1.
Roger that.
We'll be landing now.
We'll transport the doctors by piston.
I'll leave it to you.
I'm from Shohoku Doctor Heli.
What's the situation here?
How are you feeling?
Are you able to walk?
Injured passengers are concentrated in the second and third carriages.
What's the situation within the carriages?
We're still unsure of the situation in carriage 2.
Carriage 3 crashed into the carriage ahead of it,
and upon impact, the passengers collided into one another.
Is it possible for us to go in?
Carriage 3 has been confirmed for safety.
Understood.
Prepare the equipment.
Okay.
Do you feel pain here?
He's a red tag, please transfer him to an appropriate hospital.
One with an orthopedic abdominal surgery department.
Okay, I'll find one.
Please get the scene ready.
Okay, will do.
It's ready.
Okay.
Doctor, over here please.
Coming!
What time is your flight?
At 3.
Where are you headed to?
Just sending someone off.
Ah, sending off.
 田 This news just came in.
 田 In the district of Kisarazu South in Chiba prefecture, 田
 田 a 7-carriaged train from Nishiurayasu, bound for Chibayama derailed. 田
 田 Countless passengers are injured. 田
Excuse me, can you turn up the volume?
Sure.
What a terrible accident.
 田 At around 11:43 this morning, in the district of Kizarasu South in Chiba prefecture... 田
This way.
The doctors have arrived.
There are still people inside who can't move.
Will you deal with it?
This way!
Here you go.
Are you okay?
Can you hear me?
Hang in there.
Let's start with triages.
Okay.
I'm Mitsui from Shohoku Lifesaving Center.
Can you understand me?
Do you think you can walk?
Do you think you can walk?
Excuse me.
Excuse me.
A rescue team will be here shortly.
This way.
Yes.
Dr. Aizawa and Dr. Mitsui are in carriage 3.
Saejima-san, go to them.
Okay.
Carriage 2 has just been confirmed for safety.
Dr. Fujikawa, Dr. Hiyama, go there.
Got it.
Can we do a blood transfusion?
I'll check the outside.
Alright. I'll check the inside.
This way.
Okay.
What condition are the patients in?
Inside, there's a severely injured person who has been trapped.
Okay.
Once you go up, it's directly on your left.
Thanks.
Pull the rope!
Okay!
Pull the rope!
Okay!
I'm Hiyama from Shohoku Lifesaving Center.
Can you walk?
This way.
Okay.
We can't move this can we?
I'll leave it to you.
Hello? Do you understand?
Not yet...
I'm Fujikawa from the Lifesaving Center.
I'll be giving you treatment.
He has a compound fracture on his knee.
He's in shock from the hemorrhaging.
This... is my first day.
Administer the oxygen.
I'm going to take a look at your leg.
Dr. Shiraishi directed me here.
Tend to that woman over there.
Yes.
Are you okay?
Do you understand?
What's going on?
I see.
It's being reported on the news.
And so their friends and family are...
...worried about these people.
Let's save them!
 田 A 7-carriage train from Nishiurayasu bound for Chibayama derailed. 田
 田 There are a countless number who are injured. 田
 田 The effect of this incident on the Shin-Chiba rail line, has caused a cease in operation in both directions. 田
 田 As soon as details emerge as to the cause of this incident... 田
Yes?
 田 Tomo-chan? 田
 田 Are you safe? 田
 田 Hello? 田
 田 You're safe, right? 田
 田 I'm so relieved. 田
 田 Just now on TV, they showed an overturned train, and I thought that might be... 田
This is Fujikawa from the Lifesaving Center.
 田 What? 田
 田 W-where's Tomonori? 田
 田 Is Okuda Tomonori there? 田
Does Tomonori-san wear brown glasses?
 田 Yes, that's right. 田
He has been injured.
 田 What? Is he safe? 田
His leg has been injured, and we'll be taking him to the hospital soon.
 田 Wait, pass the phone to him! Let me talk to him! 田
I'm sorry.
His treatment has priority.
You will be contacted as to which hospital he'll be transported to.
 田 Hello? Hello? 田
Sorry, I'm hanging up.
Okuda-san, can you hear me?
We'll make sure to get you home.
You need to have a talk with your mother.
Do you understand?
Thank you.
Saturation has dropped!
Coming!
Follow up, please.
Okay.
Over here.
A 7.5 tube, please. I'm going to intubate.
Okay. Doctor! What about this patient?
That person has a fractured pelvis. Use a sheet for a pelvic wrap.
Understood.
Doctor!
This person's head has been hit.
Put him there for the time being.
Okay.
Doctor! This patient here has a chest injury.
Anything I can do to help?
Dr. Kuroda...
Lend me your stethoscope.
Here!
This bleeding is terrible.
Take another route. Also, perform a rapid transfusion.
You're in charge of transporting the triages?
Yes.
Take a deep breath please.
Follow the rescue team's instructions.
Yes.
Aizawa, I'll leave in here to you. I'm going to check outside.
Okay.
Please carry them out.
Yes.
Is there someone?
Child...
My child...
Aizawa from the Lifesaving Center.
Do you understand?
My child...
Rescue!
Yes!
There's someone trapped here.
Roger.
Saejima, come over here!
Coming!
I'm going to examine you.
Hayato...
Please take this person.
Yes.
He has Blumberg symptoms.
Is that person okay?
The blanch test took one second. She's yellow.
But she seems to be in a lot of pain.
What's her condition?
Her chest is in pain.
Dr. Kuroda!
Kimoto-san, where does it hurt?
My chest...
Can you describe the pain for me?
Do you feel it constricting?
Yes... as if squeezing.
I understand. I'm going to listen to your chest.
She had a heart attack. What do you have?
Suspected internal hemorrhaging within the abdomen. No signs of shock.
These patients are on priority. They need urgent transport by helicopter.
Okay!
During large-scale disasters, the chance of a heart attack increases.
Triage tagging is only the first step of the START method.
START - Simple Triage And Rapid Treatment
Don't rely on them too much.
Doctor!
We need your assistance.
Go on.
Okay!
Thank you, this way.
Yes.
The doctor is here.
Can you hear me?
I'm Hiyama from Shohoku Lifesaving Center.
Is the stretcher here yet?
I'll arrange for one now.
Could you shine the light from here?
Y-yes.
Stop moving, hold still.
This isn't good.
It's bleeding again.
What should we do?
I can't stop the bleeding with pressure.
Is there any RCC?
Could you ask my co-workers through my PHS?
Y-yes.
The right knee is fractured.
Please transport him to the ambulance.
Okay.
We have to transport him to the hospital to treat the damaged blood vessel.
Did it get through?
Not yet.
Be careful! It's going to shake!
Be careful!
Start it up!
Good!
Stop!
Hayato-kun is bleeding a bit, but it's just a scratch.
He's hanging in there.
Really?
Ma'am, do you know Hayato-kun's weight?
He's...
An approximation will do.
I'm sorry.
Due to certain reasons we don't live together.
Hayato-kun. Do you know your weight?
2-23kg.
Okay.
He was left in my mother's care.
And now that we're finally able to live together,
I went to pick him up and this happened.
I see.
Sorry, but could you hurry this up?
Hayato, are you okay?
It hurts a bit.
I'm sorry. It's all my fault, I'm sorry.
It's no good. The seat is lodged in an awkward position.
If we force it off, it will put them in trouble.
We'll get a different tool in.
Whatever we do, it'll take some time.
I'm worried about CRASH syndrome.
CRASH syndrome aka MASA syndrome, a disorder characterized mainly by mental retardation
In this situation, we can't give a transfusion or even administer oxygen.
We'll do our best.
Can't we come out yet?
Hey, Hayato!
Please calm down.
Let's all hang in there.
Why did this happen?
If only we had arrived for the next train...
Just today, the road to the station became less and less crowded...
I can't take this...
Why...?
Why Hayato...?
Hayato-chan?
Hayato-kun, can you hear me?
Hayato-kun!
What is it?
What's wrong?
Hayato, Hayato!
His right pupil is dilated.
It may be an epidural hematoma.
W-what's that?
Prepare for intubation.
What's wrong?
The doctor is checking now.
Hayato!
How much longer will it take?
Another 20 minutes.
20 minutes...
I'll ask for Dr. Saijo's opinion.
It's no use.
It won't budge.
We can't get out?
H-hey, hey, hey.
Please be careful here.
Sorry.
How is it?
It's no good, we can't get out.
So there's no choice but to cut it here.
Bring an engine cutter here.
Roger!
We have to transport him soon.
The bleeding won't stop.
And there's no blood for a transfusion.
We can't do anything while we're here.
Okuda-san, hang in there.
Fujikawa, what's the situation?
Dr. Kuroda!
Hurry up and tell me!
Yes.
The popliteal artery has been cut.
The hemorrhaging point is very deep and can't be suppressed.
Explain everything. How much has been lost?
Around 2,000cc has come out.
No blood has been transfused.
2,000cc?
He can hold for another 30 minutes.
Do you have a suture set and Satinsky clamps?
I don't have the clamps.
I do have a basic suturing set, though.
Good.
Cut open the inguinal region, and intercept the femoral artery.
Yes.
O-okay.
You're able to do it, right?
I'll do it.
Please instruct me.
What?
We're going to operate here?
With your cooperation, please.
But, today is my first day.
Also, after becoming an emergency technician, I...
I know that.
Hayato! Hayato!
Please calm down, Ma'am.
Why?
 田 So, how long will it take to transport? 田
The fastest we can get him out is in 20 minutes.
And it will take another 20 minutes by helicopter.
No matter what, it will take 40 or 50 minutes.
 田 It doesn't look like he'll make it. 田
 田 But the only option is to take him to a hospital. 田
By lowering the pressure in the head, he could hold out 40 minutes, right?
 田 How would you lower it? 田
 田 Without a drill, you won't be able to do it. 田
We'll drill it.
 田 There? 田
 田 That's absurd. How? And with what? 田
If we don't do anything, he'll die.
 田 And? 田
I'll borrow a drill from the rescue team.
Please guide me.
 田 The rescue team's drill? 田
Yes.
Dear!
Dear, say something...
Help please!
Yes?
Doctor! Doctor, please save him!
Kawano Shoji-san, 48 years.
Injuries to the head and chest. Level has increased.
Kawano-san, do you understand?
Can you hear me?
Dear! Dear, do you recognize me?
Hurry, put him on the helicopter!
Hurry!
Dear...
He'll be transported as soon as the helicopter returns.
It should be in four or five minutes.
Thank you very much.
Doctor, here please!
Scalpel.
This?
Yes, that.
Firstly, at the end of the inguinal ligament, cut an opening parallel to the blood vessel.
Pardon?
Stop that! He can't hear me!
Stop the cutting!
At the end of the inguinal ligament, cut an opening parallel to the blood vessel.
Okay.
Please shine the light from above.
Yes.
Pean forceps.
Pean?
The one with the long tip.
This one?
Yes.
I found the vascular sheath.
Next separate the arteriovenous.
Yes.
Pull the muscles back, please.
With this?
Like this?
Pull some more.
Like this?
Some more, towards yourself.
What's your name?
What?
Oh...
It's Hosoi.
I'm Fujikawa.
Let's save him together.
Alright.
Kelly forceps, please.
Kelly?
That long one.
This one?
Yes.
If you injure the femoral vein even just slightly, you'll have a major hemorrhage.
Do it cautiously.
Yes.
Listen carefully.
Hayato-kun
has a cerebral hernia,
where the blood has gathered within the skull, causing pressure to the brain.
If we don't remove it immediately...
...he'll die.
To save him...
...we need to extract the blood from inside his skull.
I will now make a hole with a drill
and remove the gathered blood.
Are you going to make a hole in his head?!
No! No!
That...
...is the only way to save Hayato-kun here.
I...
If only I hadn't gone to pick him up...!
Don't blame yourself.
It'll be okay.
 田 Ready with the local anesthesia? 田
 田 First cut through the exact middle in the temporal region, 田
 田 at the right external acoustic opening, 5cm vertically from above. 田
Okay.
 田 Have you made the cut? 田
Yes.
Let's expand the cut.
Okay.
 田 Now take the drill. 田
 田 It's not a medical drill. 田
 田 If you go in too deep, he'll die. 田
 田 An 8-year-old's skull is a little less than 2cm thick. Don't over-drill. 田
Okay.
I'm sorry... I'm sorry...
NO!!
STOP!
Noguchi-san! Noguchi-san!
Stop it! Stop it!
I beg you, stop it already, Doctor!
BE QUIET, PLEASE!
Please, don't get in the way.
We...
...want to save him, also.
Please hold his hand.
His right hand isn't numb yet.
Hayato-kun...
...should feel it, also.
I'll start now.
Next is the exterior detachment.
I don't feel any blood pressure.
Okuda-san, hang in there just a little longer!
Detachment complete.
Good.
Last thing to do is to detach the reverse part. Watch out for the deep femoral artery.
Okay.
Dry it with a gauze, please.
Right away.
Like this?
Deeper, otherwise I can't see.
Okay.
It's okay.
We'll definitely get through this.
A little bit more.
Do it with caution.
Forceps and tube.
Right away.
This?
Yes, that one.
I've clamped it.
The hemorrhage has stopped.
Well done.
We did it.
We did it!
It's not over yet, you know.
How long since the ischemia started?
ischemia - local loss of blood supply due to obstruction of the blood vessel
Perhaps 30-40 minutes.
No, a little more.
If it's within 2 hours, we can get his legs back to normal by performing revascularization at the hospital.
We'll definitely save his legs.
Yes!
Yes!
Please resume.
Okay.
Saline solution.
Yes.
 田 How is it? 田
Only the dura mater is visible now.
 田 I see. 田
 田 The hematoma hasn't crossed the cranial sutures. 田
 田 This isn't uncommon in child epidural hematoma. 田
 田 Open the front. 田
 田 6cm ahead from the point you're at now. 田
Okay.
 田 How does it look? 田
Found the hematoma.
 田 Good. Suction. 田
He's regaining conciousness.
Noguchi-san!
Hayato-kun opened his eyes.
Hayato!
Hayato!
He returned my hand grasp.
He...
...returned my hand grasp.
 田 Good. Transport him. 田
 田 Don't speed the transfusion too much while transporting him. 田
I know.
 田 You were fortunate. 田
 田 Both him 田
 田 and you. 田
Thank you.
Tobe Mari-san, 40 years old. Positive to Blumberg Sign.
Consciousness is low, pulse 108, respiration 26.
Tobe-san, it'll be okay.
I'll examine your stomach.
Doctor!
Father! Father!!
What's the matter?
Can you hear me?
Doctor?
Consciousness level dropped to 300.
Dear!
What does that mean?
Hang in there!
No! Father!!
The helicopter is here.
Please! Father!
Let's get the people over there on first.
Brain laceration has surfaced in the male here due to pain.
There's also no light reflex.
I think it's difficult to save him.
Let's give priority to those who have intra-abdominal bleeding.
I guess you're right.
I'll explain to his family.
Wait! What's the meaning of this?!
Tell me!
What's the meaning of it?!
Doctor, how's my husband doing? Doctor!
Please do something!
What's going on with my father?!
I'm sorry.
The number of people we can transport is limited.
In that case, put him on the helicopter immediately...
The patient's condition...
...is changing by the minute.
Your husband's condition has worsened considerably.
So what?
If he's deteriorated then transport him first!
I'm afraid your husband has pupillary dilation as well.
By the time he reaches the hospital, chances are...
Are you saying transporting him would be useless?
How am I supposed to accept that?!
Anyway,
what right do you have!
Being the judge of who
has priority is my job.
Who decided that?!
Wait!
Transport my father first, I beg you!
Transport him first!
Please go.
Okay.
You!
Are you just going to let my father die?!
Please abide by my indications.
You're cruel.
How can you say such a thing unconcernedly?
Isn't he still warm?
Isn't he still so warm?
Excuse me.
Transport the seriously wounded to the white tent, please.
Can you hear me?
Can you talk?
Good work!
She's not picking up.
Who?
Hiyama.
Isn't it strange?
Shiraishi.
It seems things have settled down here, so go back to Shohoku on the next helicopter.
Okay.
I'll wait for Hiyama.
Dr. Mitsui, please go back on the next helicopter as well.
I'll leave it to you then.
 田 The 7-carriage train from Nishiurayasu bound for Chibayama derailed. 田
 田 In this Shinchiba railroad accident, confirmed at present are 5 dead, 田
 田 16 severely injured, 田
 田 and 41 with minor injuries. 田
 田 The tough rescue of casualties is coming to a close. 田
 田 Special Safeguarded Retirement Home Seiun no Sato Application Form
 田 From the Shinchiba railroad accident undergoing treatment at this hospital
Is the family of Okuda Etsuko-san present?
But I'm sure he was on that train, there's no mistake!
This is the last patient here. Take care of her.
Okay.
Ten minutes left till sunset. We won't be able to fly.
There aren't anymore red tags, right?
Everything's fine.
 田 Hiyama
What is it?
Where have you been?
 田 It's me. 田
Dr. Kuroda.
 田 Come ASAP. I'm at the reverse side of the second carriage. 田
Okay.
I'll take over.
Thank you.
Cardiac arrest for how long?
I don't know. I just came a minute ago.
Windward safety came through. We can fly at any moment.
Please.
Do an echo, fast.
She's had a strong impact on her chest. She might have cardiac tamponade.
We'll do pericardiocentesis, right?
Exactly.
Prepare the syringe.
Do a CT for the thoracoabdominal.
Okay. I'll make preparations.
You!
Are you just going to let my father die?!
Please abide by my indications.
What's wrong?
Hm?
Ah, nothing...
Dr. Morimoto, is it a red tag?
It's Hiyama.
I've extracted 120cc.
Heart rate has resumed.
I'll clamp it temporarily.
Blood pressure is up.
Good. Let's get her out of here.
 田 And how long was she in cardiac arrest? 田
We don't know.
 田 You have no idea how much damage the brain has suffered? 田
No.
Let's open the pericardium.
Okay.
Watch out for the phrenic nerve.
I'll cut it open.
There it is.
The right auricle is damaged.
I'll stitch it.
Blood pressure isn't rising.
Bleeding won't stop.
It's not just the right auricle.
We can't do much more here.
Heart surgeons are on stand-by.
Take her to the OR.
Yes.
Step on it!
Yes!
Overturn the heart.
Yes.
Aah, as I thought.
The left atrium is damaged, also.
Can you clip it with a Satinsky forcep?
I'll try to.
What about the farewell...?
Did you go to the airport?
Of course not.
What about Hiyama's family?
Right.
I called her father earlier.
How did it go?
It seems they were able to stitch the damaged part of the heart.
Her vitals
have also settled down.
But...
As for the brain...
They can't say whether or not she'll regain consciousness.
 田 Do NOT upload this onto streaming sites! Get this FREE at d-addicts.com! Not for sale or rent!
You on duty?
Yeah, Dr. Mitsui and I.
You're here?
Yeah.
I still have some work left to do.
I'll be here till morning.
Shiraishi.
Yes?
That triage earlier...
...was not wrong.
You did well coping with it calmly.
That's because it was always done like that...
...by you.
I see.
The triage is a tough task,
isn't it?
That's why
I had you do it.
Dr. Kuroda won't be there from now on.
We need all of you
to grow a lot more.
Doctor.
Hm?
May I cry now?
Aren't you on the airplane?
 田 There was a train accident, right? 田
 田 I saw it on the news. 田
 田 I thought, maybe you were there. 田
 田 I've extended our stay till tomorrow. 田
 田 Do you think you can come tomorrow? 田
I don't know.
A Fellowship member got injured.
 田 What happened? 田
She's still unconscious.
 田 I see... 田
 田 Don't worry about us. 田
 田 Stay with her. 田
Yeah.
 田 See you. 田
Oh, Yuriko.
Why did you extend it till tomorrow?
 田 No reason. 田
 田 There's no reason. 田
 田 I just... 田
 田 ...thought I should try to change myself a little, also. 田
Hm?
 田 Since you 田
 田 Have changed. 田
 田 I'll do that, also. 田
 田 Just a little. 田
Is that so?
 田 Yep. 田
 田 Bye. 田
Yeah.
How may I help you?
I'm Hiyama's father.
Dr. Hiyama is currently in ICU.
How's she doing?
You'll have to ask the lifesaving doctors for the details.
So the brain surgeons say it's a two- to three-day fight.
A waiting room has been prepared, so
whenever you need to rest, you can do so there.
Excuse me.
Are these my daughter's belongings?
Yes.
Why don't you let your mother hear your voice?
Though, she might already be here.
Okay.
Oh, Mom?
It's me.
I'm fine.
Yes.
I was examined by a good doctor.
I was rescued by the doctor.
It's just like Dr. Hiyama said.
It was skin lesion.
Konno-san's operation ended.
He woke up a little while ago.
Really?
That's a relief.
The family would like to thank Dr. Hiyama.
I see.
Me, also.
I want to thank her.
Thanks to her Konno-san was saved.
The first time I met her,
I was surprised.
Saying whatever bluntly
and barging into people's feelings.
But...
Actually, she's a kind doctor.
Always thinking of her patients,
getting unintentionally worked up.
Understand her.
She's a good doctor, isn't she?
Somehow...
I feel like we've been friends for a really long time.
Hiyama-san.
Is it because of bad upbringing by the parents
that she's been selfish since long ago.
Whenever I scolded her, she'd double that in complaints.
She really was only good with words.
Yet...
Right now,
she's got all those tubes.
Such things inserted in her mouth.
She was at home till yesterday.
Even though it had been several years since we last met,
we ended up arguing.
I see.
At a whim, Mihoko
made a taro stew.
"This tastes so bad!"
And then,
"Can't you even make something like this properly?"
"Since you're a doctor you say everything so patronizingly,
but you're only half a person at best, aren't you?"
When in reality...
I think she's really admirable.
Being born into a normal family,
working hard with her own strength and becoming a doctor.
If I had known this was going to happen...
I should have told her.
You're right.
There are words
that should be said.
Words that make you regretful
if you don't convey them when you can.
Doctor.
Doctor!
Hiyama?
I...
Why...?
Mihoko.
Father...
Why are you here?
You fell from the train carriage.
Then you had cardiac tamponade and were brought here.
Oh...
At that moment...
Do you remember?
Yes.
I was rescued.
Yes.
Mihoko.
Come on! You're embarrassing me!
Mihoko.
Father.
How are you feeling?
I'm sorry.
Don't worry.
The most important thing is you were rescued.
I...
Hm?
The triage.
I failed
and was scolded
by Dr. Kuroda.
It's okay.
People grow by repeatedly making mistakes.
While you're in the Fellowship...
It's a good time to make mistakes.
But we can't allow doctors to make mistakes.
That's the difficult part.
Don't be rushed.
Become a doctor
with a broad perspective.
Okay.
What is it?
My heart.
Where you the one to stitch it?
Well... Yeah.
Is it okay?
Did you stitch it properly?
Probably.
Dr. Kuroda!
About yesterday.
Thank you.
I don't want your gratitude.
I'm not your instructing doctor anymore.
From now on, also...
Please continue being the instructing doctor.
Among the Fellowship members I've seen till now,
you guys are the worst.
So conceited,
weak to pain,
arrogant to the point of narcissism.
Really the worst.
Grandma!
You shouldn't have come.
You're busy, right?
Do your best.
Won't you live with me?
Let's live together, Grandma.
What are you talking about?
You have your work, don't you?
How will you manage if we live together?
Can you work while taking care of such an elderly person?
There's no way you can.
When you got into university,
you left home.
I never heard from you since.
I was happy, you know.
You finally became an independent person.
Such a tiny crybaby,
always walking restlessly behind me,
is now standing on his own two feet.
I'm okay with just that.
Grandma...
There are many companions where I'm going.
I look forward to it.
Dr. Hiyama is fine, right?
Yeah.
I'm glad.
Dr. Shiraishi.
Dr. Fujikawa.
Saejima-san.
They all came to see me.
Everyone was praising you.
Almost shamelessly.
I'm glad you made some good friends.
Yeah.
See you.
I really bothered you a lot, didn't I?
Thank you.
I'm really glad that...
I got to see
where you work.
I was scolded when I asked her to live with me.
Wasn't that still a lovely parting?
Since it's not like you won't ever meet again.
Why don't you go see her when you have some time?
You're right.
Of course I am.
Oh! Over here!
Sit down.
How are you doing?
So-so. I'm feeling better.
We've finally gathered.
But you know, my whole body still hurts.
Don't say that.
It's also your recovery party.
Oh, by the way,
once you're fully recovered,
why don't we go have a drink at a stylish bar?
What are you talking about?
'Cause...
From now on, we'll be the ones to support Lifesaving, right?
To celebrate that decision, or...
I'm busy.
You have spare time, don't you?
By all means, on your own.
What's with you?
After I went through the trouble of gathering everyone...
Wait a minute! Hey!
I have to clear all this up?!
Why did you come eat...
What the hell!
Right?
Oh, wait!
Hey!
What's wrong with Nakamura-san?
I'll be right there.
Parting will surely come.
At any time.
How's your leg?
Oh, really?
That's a relief.
VF!
Yes.
discharge - for defibrillator
Prepare for DC.
But... We know.
And intubation. Quick!
Just as there are sad farewells,
Hang in there!
there are farewells for departures
and farewells for facing the future...
So, eat a lot more
and you'll be discharged in no time!
You're at the hospital. Do you understand?
Transfering him.
1, 2, 3!
The team that you and Dr. Kuroda created.
They can take over, right?
Suction.
He has a history of asthma.
FAST is negative.
Adding a line.
Okay.
10 units of RCC.
Yes!
Take him to the OR.
And, we know...
The only certainty is
that separation
makes people strong.