The Federal Unites Air Force attacks the Ortega republic accusing its leader General Cruz of international criminal activities. Meanwhile, Black Jack is asked by a woman called Maria to operate on an unknown person. During transit, Ortega forces free Cruz, and Captain Maria Carnella is shot in the eye. She contacts Jack who says the patient is Cruz who is dying from cancer. On the perilous journey back to Ortega, Black Jack operates under moonlight to remove a cancerous lesion on Cruz's thyroid gland to prolong his life. Meanwhile, Federal Unites elite forces attack and the Ortega forces create a diversion, however they are defeated and Maria gives her life to save her father, General Cruz. Jack carries Cruz to the border, but he is killed under orders of Federal Unites President Kelly. Later, back home, Pinoko finds Maria Carnella's dog tags in a drawer.