Byouin no Naoshikata (Byouin no Naoshikata ~ Dr Arihara no Chousen / 病院の治しかた〜ドクター有原の挑戦〜)

One day, suddenly, from the city you're living in,

a hospital disappears.

Such a shocking future

is going to become a reality now.

The lack of doctors, increasing medical costs, decreasing treatment fees,

and declining birth rate add to the worsening situation.

While many hospitals fall into a critical state,

there was a doctor who stood up bravely to protect local healthcare.

Why did a local hospital on the verge of bankruptcy

transform into one of the best hospitals in Japan?

This is a miraculous reform story of a hospital which started from

a doctor and a manager's strong belief.

How to Cure a Hospital

Tokyo

With this next-generation stent, catheter treatment

not only saves the lives of patients with heart disease,

32nd Circulatory Organs Internal Medicine Conference

but also results in better prognosis and

is a method which will improve quality of life.

Toto University Hospital Internal Medicine, Associate Professor

Arihara Shuhei

Dr. Arihara, what is the future research goal?

Development of stents made from biological materials.

Clinical evidence is still lacking but if we push for practical use,

the prognosis should improve dramatically.

Toto University Hospital has many achievements in treatment.

With your research results, its evaluation will rise further.

- I will do my best to meet your expectation. - I will look forward to it.

- Thank you. - Thank you.

- Yes. - Ah, it's me.

- Dad? - Can you speak now?

What is it? Something urgent?

No... I want to discuss something.

Can you come back here soon?

- No, not for the time being. - Hey, Arihara.

I'll go back for Mom's 13th death anniversary.

Sorry, I'm busy right now. I'll call you back later. Bye.

Sorry about that.

Yamanashi Prefecture, Kofu City

Shuhei's father, Arihara General Hospital, Honorary Director

Arihara Shotaro

13th death anniversary? That's still far ahead.

Thanks for your hard work at the medical conference.

Sorry for staying out continuously and being away from home.

It's alright. Thanks to that, I could work overtime without reserve.

Here's a newly-made sample.

I thought I was going to die from designing the entire book.

Excuse me. Thanks for waiting. Two draft beers.

- Thank you. - Thank you.

Thanks for your hard work too.

Anyway, let's toast for now.

Then...

Shuhei's wife, Editorial Designer

Arihara Shiho

Cheers!

Yummy!

So how was the reaction to your research presentation?

- Thankfully, it was great. - Congratulations.

But now the real challenge begins for the research.

- I need to improve the stent quickly too. - Stent?

Yes, a metal tube that widens clogged blood vessels.

Drug-eluting stents can reduce restenosis,

but leaving metal in the body may have risks so

we have to shift to using bioresorbable stents made from

biological materials as soon as possible...

Oh, sorry. I couldn't help it...

It's alright. I'm listening.

I don't... understand at all though.

A call from the university hospital?

No, it's from my dad.

Hello?

Dr. Shuhei? I'm Hyodo.

Oh, Etsuko-san. It's been a while.

The head nurse from my family's hospital.

- What's the matter? - Dr. Shotaro collapsed.

- What happened to my dad? - He collapsed. From a stroke.

Opening the hind door!

I'll get the doctor.

- Nurse, nurse! Hurry! - Please wait a little longer. Sorry.

Stretcher coming through.

We've reached the hospital.

- Turning the stretcher. - Excuse me!

- When can we see the doctor? - Please wait a little longer.

An internal medicine doctor will be here soon.

Are you okay? Ueyama? Ueyama!

- Are you okay? Hey! - What's wrong?

He's suffering. Hurry... What? You're not the doctor.

I'll take your pulse.

- Since when? - What?

- When did his chest pain start? - More than an hour ago. No, before that.

He felt unwell during the farewell party.

He said he would wait and see but then his chest hurt.

Hey, are you okay?!

Ueyama-san, can you hear me?

He vomited, huh...

- This is... - What are you doing there?

Please don't do anything to our patient.

- No, I... - Dr. Uno, over here.

- Please see him. He has chest pain. - Myocardial infarction?

- Arrange an ECG at once. - Yes.

- Ueyama-san, I'm putting you on a wheelchair. - Let's go.

- Let's go. - Please take care of him.

- Ueyama, hang in there! - Are you okay?

- When did she start coughing? - Her cough worsened since evening.

She has a fever of 38.8 degrees C.

- Can you tell me your name? - Ayana.

Ayana-chan, can you look up and see my face?

I'll take off your mask. It won't hurt. Look here.

Internal Medicine Nurse

Shono Hiromi

Internal Medicine Doctor

Uno Hitoshi

How strange. The wave pattern is normal.

Hey, you!

If it's not a myocardial infarction, it's likely to be an oesophageal rupture.

Contact the lab. Prepare the contrast agent at once and

- take a CT scan of his chest. - Who are you?

- An outsider should get out! - The patient vomited before he came here.

From palpation, I noticed he had subcutaneous emphysema.

I think it's an oesophageal rupture.

If we don't hurry, it will result in sepsis.

Two hours have already passed since he vomited.

Ueyama-san, are you okay?

Please breathe in slowly.

Over there. A strange person appeared suddenly.

- Strange person...? - A suspicious person.

Head Nurse, Internal Medicine Chief

Hyodo Etsuko

The contrast agent is leaking.

There's a vertical rupture in the lower left oesophagus wall.

- Where's the surgical doctor on duty? - In an operation.

A seriously injured patient from a traffic accident was transported here earlier...

- Any other doctors who can operate on him? - None today.

The surgical chief has gone to Osaka for work.

- What about the university hospital? - I think accepting him will be difficult.

Many injured people from a factory fire were transported there.

There's no other way. Let's send him to Otsuki's city hospital.

- No, let's treat him here. - What?

It will take at least 40 minutes to reach Otsuki.

The rupture site is about 30 mm.

Even without thoracotomy, if a covered stent is inserted using an endoscope,

- the hole can be sealed. - No, no...

His general condition is not bad. Let's perform intrathoracic washing,

- drainage and use antibiotics. - What are you saying?!

- Head Nurse, over here. - Etsuko-san, perfect timing.

- What? - I want to insert a stent into his oesophagus.

The patient has an oesophageal rupture. It's an emergency.

Internal Medicine Nurse

Hongo Mari

- Yes. Prepare the endoscope room at once. - Yes.

Head Nurse, don't follow the orders of this stranger...

It's fine. Dr. Shuhei is an established doctor in stent treatment.

Dr. Shuhei... The previous director's son?!

Dr. Uno, I will treat Ueyama-san.

Please take care of the patient in the waiting room.

A girl with fever. Her mother is worried so

- please see her quickly. - Yes...

We will begin the procedure to seal the oesophagal rupture with a covered stent.

Yes.

- Lidocaine, please. - Yes.

- Here. - Then, let's begin.

- Please monitor his condition. - Yes.

Please take him.

- Etsuko-san. - Yes.

Where's Dad?

Yes...

Come in.

A large infarct in his brainstem.

Sorry. If only we had discovered it earlier.

No...

We thought he went home after consultations were over.

Though he quit being the director, he said he would continue his consultations

so I thought he was still healthy...

Even so, you haven't been back for 6 years.

Dr. Shuhei, do you know how much debts this hospital

- is burdened with now? - What? No...

Six years ago, ever since Dr. Kenjiro took over as director,

it only got worse.

Dr. Shotaro actually wanted to discuss that with you earlier.

But he couldn't say it.

Because he knew it would burden you if he told you.

This is...

These figures are terminal.

Shinkai Bank Head Office

I heard the previous director collapsed?

He has not regained consciousness yet.

Shinkai Bank, Loan Section Chief

Morinaga Ikuo

He's old already. It'll be difficult for him to return to work.

I see... Kurashima-kun, what do you think?

Shinkai Bank, Managing Director

Kiriyama Kozo

Shinkai Bank, Loan Section Vice Chief

Kurashima Ryosuke

Any prospect of this hospital recovering from its deficit?

It will be difficult in the current situation.

Right. If this was an ordinary corporation, it would be bankrupt already.

As I thought, we should utilise the hospital reform fund

- according to Managing Director's suggestion. - Yes.

Medical Partners contacted us that