He is one of the very best neurosurgeons in Germany because of his social and medical skills. He loves people and always makes the best of every operation. Nevertheless, he feels ill at ease because of the decisions of the superiors: He has to give important and rich people preference to increase the reputation of the hospital. This is incompatible with Tenma's own opinion on equality. Over the course of the story, Tenma has to treat several patients and he is forced to prefer the people who are more important and influential. Later, he notices what he did, when he is ordered to operate a politician instead of a small boy who suffers from enormous blood loss – as a result of a head shot – . Tenma decides to ignore the order and continue operating on this small boy named Johann. However, soon it becomes clear to Tenma that Johann is not just a "normal" boy.