Monster Episode 1 -

: The surgery is a success, but the Mayor dies under the care of other surgeons.

The episode introduces Tenma's internal struggle through two pivotal moments: Monster Episode 1

While Tenma is at his lowest, the hospital leadership—including the Director and the doctors who replaced Tenma—are suddenly and mysteriously murdered. With his rivals gone, Tenma is ironically promoted to Chief of Surgery, but the boy he saved, Johan, has vanished from the hospital along with his sister. : The surgery is a success, but the

: Tenma's belief in saving everyone is pitted against the cold, political reality of the hospital. : Tenma's belief in saving everyone is pitted

Haunted by his previous choice, Tenma defies orders and stays to operate on Johan.

: When twin children, Johan and Anna Liebert, are brought in after a brutal massacre of their foster parents, Tenma prepares to operate on the boy, Johan, who has a critical head wound. Moments before the surgery, the Mayor of Düsseldorf is admitted with a stroke. The Director orders Tenma to abandon the boy to save the high-profile politician. The Climax: Saving a "Monster"

The episode ends by setting a 9-year time jump, where Tenma will eventually realize that the life he sacrificed everything to save was that of a sociopathic killer.