Yasuhiko Shirabyoshi, the wealthy chief of surgery at the Tozai University is shocked when his fiancée, Catherine, asks for a six month postponement of their wedding, because she has volunteered to provide medical assistance for people affected by the civil war in Adentarl. Catherine encounters Jack on her way to a refugee camp, where he searches for a girl called Karen Aramis on behalf of her mother, Saranda and crime boss grandfather Patterson, because she has the hereditary heart ailment, Tetralogy of Fallot. Jack operates on her in a field hospital assisted by Catherine who travels back to New York by helicopter while Jack stays to treat the refugees. He refuses to work in the camp for free and demands one dollar per patient. Meanwhile, the immanent Dr. Stanfield calls together a panel of the International Medical Association (IMA). He proposes that Jack be granted an international medical licence, because he believes that medical ability is not a case of black or white, however Shirabyoshi objects. Jack arrives in New York, and while at a karaoke bar, Patterson is shot and rushed to hospital. Shirabyoshi refuses to allow Jack to operate without a licence and commences surgery to remove the bullets himself. However, Shirabyoshi lacks the practical experience, and he allows Jack to finish the surgery. A month later the IMA unanimously vote to grant jack a medical licence, but he is not present. Back at home, Jack receives a large package from Adentarl containing many IOUs for one dollar.