Black Pean Information #27

[tronella]

Medical commentary on episode 8 (1)

As we enter the final stages and the battle of geniuses between Dr Tokai and Dr Saeki grows deeper, this story’s mysteries are starting to come clear one by one. In episode 8, Dr Tokai doesn’t perform any surgery, so I’d like to look back at Dr Saeki’s surgeries.

Professor Saeki’s mistake

As usual, Dr Sera and the other surgeons watched Dr Saeki operating on the monitor. Head Nurse Fujiwara passed Dr Saeki a scalpel, and he was about to cut into the left atrium when something came over him and he dropped the scalpel onto the operating field.

We’ve been discussing “scalpel work” for a long time, and I’m sure many people think that all surgery scenes start with the word “scalpel” and use scalpels a lot throughout. However, when I was a student observing surgeries, what left the greatest impression on me was how they didn’t use scalpels at all when operating. They are only used to cut into the skin at the beginning, or they are inserted into the left atrium or aorta or used to open the chest like in this case. This is because scalpels are extremely sharp, and if someone were to drop a scalpel onto the operating field like in this scene, in the worst case it could cut through a lot of tissue or cut open things that should never be cut, causing a great tragedy, so wherever possible medical scissors like Metzenbaum scissors are used to cut tissue when this is needed. When a scalpel is used, the assistants and nurses all slightly change their posture, unconsciously shifting into a defensive mode. When a scalpel is passed to the lead surgeon, used to cut tissue and returned to the scrub nurse, like we saw in this drama, it is placed in a metal dish called a kidney basin. If someone’s hand got in the way, it would be stabbed by the scalpel and this would cause a big problem, so everyone including the surgeon is extremely cautious whenever a scalpel is being used. In that situation, Dr Saeki dropped the scalpel. This couldn’t be seen on the monitor, but it hit the pulmonary artery, which had to be repaired. Since it was repaired immediately there were no problems, but it was a very tense moment.

Reproducing the operating room

This time, the original author Dr Kaidou Takeru appeared on screen, and I had the chance to meet him too. He said “the operating room has been reproduced extremely well. There have been many medical dramas so far, but we could say this is what an operating room is really like.” Those words made me very happy. The staff members have visited various hospitals, observed their operating rooms and collected very detailed information, paid attention to the smallest details and tried to make it realistic, and this is the result. The first time I saw the operating room set, I felt it was set up in such a way that you might really be able to operate in there. I was really surprised to see the monitor set-up, the carelessly-placed bin, the tray for counting gauze, the shelves of gloves, gowns, gauze and drapes, the glove size chart stuck to the wall with “Tojo University Hospital Operating Room” written at the bottom in a small font and all the small details here and there. Of course, a real operating room is definitely well-ordered, but of course in reality there is some mess as well, and I think that disordered order has been shown really well.

The same is true for the operating room corridor. There are large shelves with various items on them, with anaesthesia equipment, the heart-lung machine and the ultrasound machine in the corner, and during filming the actors really went to get those devices from there. I felt the realism of things that are actually being used oozing out through the screen. And Dr Tokai’s room is the same too - I was very surprised by the extent to which they reproduced the atmosphere of the surgeons’ living space. Once when I was on set, I hid in Dr Tokai’s room and actually worked on that sofa, but first I looked carefully at the desk in front of the sofa, where Dr Tokai often keeps his phone, and deep underneath the stacks of papers I found a familiar-looking set of 60 colouring pencils hidden there. They were the same pencils that I use every day when writing surgery reports. There must have been a staff member who went to my workplace and saw those colouring pencils on my desk, took a photo of them and went to buy them at a stationery shop, I imagined... I could feel how much hard work had gone into that set. Even though it can’t be seen on screen, they go into that much detail. That showed me how tenacious these staff members and artists are.

The documents in the medical office are real hospital-related documents too. The books are all real medical books, the papers are real too, and I happened to spot some of my own papers in there as well, which made me happy. I’m sure you can’t see that on screen, though. When I said “good work” to the staff members cleaning up the medical office, they told me “doctor, you can have this book. I bought it myself but I finished it already. Here you go,” and gave me the latest issue of a medical journal I often read myself. When I asked “did you buy this yourself?” they said “we went and bought all sorts of things”. Don’t you think the staff members could become medical workers too? Wouldn’t you normally just go to some hospital’s medical library or archives, borrow some old medical texts and line them up? But they went and bought them themselves and even read them - how serious. Buying the latest medical journals themselves, reading them and putting them in the medical office adds some serious realism to the set, showing me again how tenacious the staff members and artists are.

Let’s return to the main topic, reproducing the operation room and the surgeries. In order to make the surgeries seem realistic, we all discussed them together from the rehearsal stage. A scrub nurse from my hospital came to discuss the placement of instrument trays and surgical instruments too, so we could decide on them in detail. The biggest difference between Black Pean’s surgery scenes and those of other dramas is that in Black Pean we approach all of them as heart surgeries that could be performed in the real world. Most other dramas only show surgeries performed by cutting open the chest with a midline incision,but in Black Pean we have various types of surgical approach like left thoracotomy, right thoracotomy, catheterisation and robot-assisted surgery. These each have their own layouts for instrument trays and surgical instruments, as well as different equipment (e.g. X-ray machines or heart-lung machines) and equipment set-ups. The staff in charge of collecting detailed medical information said “this hospital uses this kind of set-up”, and I explained the set-up at my own hospital, then we considered various different approaches to make things easier for the actors to work and to look better on screen to find the most appropriate version.

For example, each scene was set-up in great detail, considering things like in this scene Dr Saeki is operating so there isn’t much bleeding, so his gown should only have a very small amount of blood on it, whereas Dr Tokai would probably have about this much blood. How much blood should there be on the assistants’ gowns and gloves? Should the magnifiers (those telescope-like glasses) be up or down? Should Nekota be wearing goggles here? How much gauze should there be and where should it be placed? How many bloodstains are there? How disorganised should the medical devices be? Are they using 4-0 thread, or 3-0, or something else? Is the heart-lung machine running or not? Is it set up or not? What temperature is it set at? Has the heart been stopped or not? If not, what is the pulse rate? And so on.

We also paid a lot of attention to the lighting. In the novel “Black Pean 1988", a scene where Dr Sera is watching Dr Tokai and Dr Takashina operate gives the following description: “They looked just like a Catholic priest and nun in a religious painting. Sera watched that peaceful world with fascination for a moment.” I think the balance of light and shadows in every scene really represented that well, and I’m always to see the operating room scenes looking like a Vermeer painting.

I think having all these small details make it possible to create these realistic surgery scenes.

--

There are only two episodes to go. In episode 9 and the last episode, we’ll see many types of surgery that we’ve never seen before, and we’ll see Dr Tokai, Dr Sera, Hanabusa, Dr Takashina and Nekota in new lights. Of course, we will also see Dr Tokai using his true abilities, and the teamwork of Tojo’s Opengers will also reach new heights.

The origin of Dr Tokai’s genius-level surgical skills, his feelings about his father, the mystery of the black pean, whether Dr Saeki is good or evil... all these mysteries will become clear. I’m not the only one who got excited in the corner of the set at everyone’s realistic, blood-curdling acting. Beyond the theme of “human skill vs new medical devices”, I think this story will reach even greater depths.

Next time, I’ll talk about Dr Saeki’s “MICS Saeki method”.

Comments

[whiteleaves0]

Thanks so much for translating! I love hearing about how the staff go to great lengths to manufacture the tiny details they picked up on from a hospital like colouring pencils, and exactly how each tool and costume should look throughout a surgery.

(I think you might be missing a bracket from the novel's name near the end of the information, and I'm probably wrong but I thought the surgery team's nickname was Opengers instead of Opevengers?)

[tronella.livejournal.com]

Oops, you're right. Thanks for the corrections.

I'm really glad they're posting these detailed commentaries. It's very interesting to see how much work they put into everything :D