Dr. Kenzo Tenma, a leading neurosurgeon at the Dusseldorf Hospital has received massive acclaim for his successful surgery on a famous opera singer. However, he is burdened by guilt. Due to pressure from the director, he had operated on the opera singer on the night that he was supposed to operate on another man. As a result, when the director’s orders him to operate on the mayor, he decides to ignore the order and instead works on saving the life of a young boy, brought to the hospital from the scene of a serial homicide. However, the boy's twin sister, who was brought in with the boy, and who still suffers from shock, keeps repeating the words 'kill him'.

The price for disobeying Dr. Heinemann's orders to operate on the mayor is costly for Dr. Tenma. His career begins to plummet. The boy whom he saved finally awakens, but a horrible incident occurs soon after.

Nina finally receives an email informing her to meet the anonymous sender at a specified time and place. Dr. Tenma in his search for the Liebert girl, asks Mauler, an editor for a local publisher, for assistance in his investigations.

Eva tries to threaten Dr. Tenma, unless he gets back with her, she would reveal to the police that the tie that was found at the scene of the crime is his!

Dr. Tenma has a gun pointed at Roberto, but Roberto has the rifle pointed at him. Nina, Dr.Reichwen and Dieter arrive to find the whole library in flames. People are trapped inside and the doors are all locked. Karl reads the report on his mother's life and death. Dr. Tenma tries to rescue those trapped in the building. Johan reveals the monster inside of him to Schuwald.

Nina confronts Johan who presents her with a story on what happened when many people were poisoned at the Mansion of Red Roses. Nina realizes that she was the one who witnessed these deaths, the shock of this revelation nearly drives her to suicide, but she is saved by Tenma. Capek is gunned down by members of his organization when they find out about the guard that Capek killed.

Bonaparta attempts to shoot Johan dead, but is gunned down by Roberto, who dies of his own injuries soon afterwards. With the massacre now over, authorities rush into the town and attempt to determine what happened. Just as an officer is about to arrest Dr. Tenma, an ambulance worker arrives asking for Tenma's assistance.

It has been some time since the tragic blood battle, and everyone is working hard to put their lives back to normal. Tenma finally locates a woman he has been searching for, and she reveals some startling information.