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A faint smile appeared on Tsunade's face at once.
Clearly, Uchiha Gen's answer had pleased her.
Then those bright, striking eyes dropped to the test paper he had completed, scanning through it with practiced speed.
"Have you studied any medical theory before this?" Tsunade asked suddenly.
"Only the most basic anatomy we learned in class," Gen answered honestly. "Enough to know which parts of the body are most effective for killing, and enough to perform emergency bandaging and bleeding control on the battlefield. That's all."
"Then Orochimaru was right," Tsunade said, setting the paper down for a moment. "You really do have a talent for absorbing theoretical knowledge."
She tapped the test paper lightly with one finger.
"Most of your answers are correct. More importantly, every answer follows a standard medical logic and can be traced back to the materials I gave you. Real treatment will always vary depending on the situation, but for now... I'm satisfied. Come with me. This afternoon, I'll explain the next stage of medical ninjutsu training and prepare the materials you'll need. After that, you can study on your own, just like before. And remember—write down every insight you gain during the process."
"Yes, Lady Tsunade."
Soon, Gen followed Tsunade out of the room and into another chamber nearby.
This one was cleaner, colder, and more clinical. Cabinets lined the walls, filled with bottles, instruments, and neatly organized bundles of prepared materials. A broad worktable sat in the center, already scrubbed spotless.
Tsunade cleared away a few things on the table, then strode out again without another word.
She returned not long after, carrying a rabbit by the ears.
"I just bought this for meat," she said matter-of-factly. "Now it gets to serve as today's teaching aid. Watch carefully. I'm going to teach you the most basic and most practical medical ninjutsu of all—the Hemostasis Technique. It's only C-rank in difficulty, and it doesn't require any especially unusual chakra characteristics. If your fundamentals are good enough, you should be able to learn it."
Tsunade had always been like this. Decisive. Efficient. Once she decided to teach something, she went straight to the point.
"On the battlefield, this technique often has to be used without anesthesia," she said while setting the rabbit down. "You can't always afford to dull a comrade's senses or interfere with their ability to keep fighting. But this is a lesson, not a battlefield, so we'll follow proper procedure. If the rabbit keeps struggling, it'll only affect the demonstration."
She reached for a syringe and a small vial.
"Of course, if your perception is refined enough and you've mastered a high-level medical ninjutsu like the Chakra Scalpel, you can sever the local nerves directly and eliminate the need for anesthesia that way. But that's far beyond where you are now. We'll start from the most basic level."
As she spoke, she drew a measured amount of anesthetic into the syringe.
"The formula for this anesthetic appeared in the exam paper you just took, so I won't waste time explaining how it's prepared. For now, just watch what I do."
The needle pierced the ear vein with clean precision.
Then Tsunade began walking him through every step in detail—how to observe the rabbit's reaction, how to check the corneal reflex, how to judge muscle relaxation, how to determine whether the dosage had taken effect properly, and what kind of warning signs to watch for if something went wrong.
Only after that did she begin removing the fur around the treatment area.
Gen stood nearby without speaking, his attention focused to the extreme.
At some point, he had quietly activated his Sharingan. The single tomoe in each eye rotated slowly, capturing every movement Tsunade made with as much clarity as he could manage.
A one-tomoe Sharingan could not truly be called a copying eye. To reach that point, the eye had to at least evolve to two tomoe. But even in its current state, it was still useful when it came to observing action-based techniques. As for following the direction and circulation of chakra, blurred though it was, it was still better than nothing.
Once the preparation was complete, Tsunade made a small incision.
Blood welled up almost instantly.
Then she placed her hand over the wound.
Green chakra gathered in her palm, soft and controlled, bathing the wound in a warm glow. The bleeding slowed, then stopped entirely within seconds.
"That's the Hemostasis Technique," Tsunade said. "At the most basic level, it stimulates local tissue activity, promotes clotting, and temporarily stabilizes the wound. It's not a true replacement for full treatment, but on the battlefield, it buys time. And time is life."
She withdrew her hand, then continued the explanation without pause.
"After that, you usually apply a bandage. How tightly you wrap it depends on the severity of the wound and how successful the hemostasis was. If the wound is deep or wide, sutures can be used first to reinforce the tissue before applying the technique. That lowers the difficulty of maintaining hemostasis and reduces the chance of the wound reopening."
To demonstrate, she picked up a scalpel again and cut a longer wound.
"Like this. This kind of injury should not be handled carelessly."
Gen nodded quietly, committing every word to memory.
This rabbit was truly pitiful. After serving as Tsunade's demonstration subject, it would have to endure Gen's practice next.
Tsunade's own skill was extraordinary. By the time she finished explaining, the rabbit had lost very little blood, and the original demonstration wound had already been healed almost completely by her medical chakra.
But when Gen took over, the process became far more difficult.
Even during the second attempt, he lost control for an instant. The chakra output spiked, and instead of gently sealing the wound, he scorched the flesh around it.
To be fair, it did stop the bleeding.
Just in the most violent way possible.
Tsunade's brows drew together.
"Again," she said.
Gen lowered his eyes to the rabbit, mind racing.
Something was wrong.
His chakra control should have been more than good enough for this level of technique. In terms of pure precision, he was better than many beginners. Yet when he attempted to use Yang Release medical chakra, something in the output kept skewing. The result wasn't pure healing. It leaned toward burning.
In that instant, a memory surfaced.
He remembered a scene from the original story—Sarada, trying to imitate Sakura, accidentally turning a healing attempt into something closer to cooking the target alive.
At the time, it had just been comedic.
Now, standing here in person, Gen suddenly realized it might not have been comedy at all.
He had spent enough time in the ninja world by now to understand one thing clearly: he had never once heard of an Uchiha being famous for medical ninjutsu.
Why?
Because medical ninjutsu was, at its core, a Yang Release discipline.
And the Uchiha were the embodiment of Yin Release.
Their bloodline leaned heavily toward spiritual power, ocular power, illusion, and fire. Even though every chakra system contained both Yin and Yang, the Sharingan itself was the clearest manifestation of Yin. Once the Yin aspect became too dominant, other compatible natures—especially Fire Release—could surface naturally when chakra was shaped incorrectly.
That would explain everything.
It would also explain why he had not simply incinerated the rabbit on the spot.
The fact that he had only singed the wound meant his control was already extremely high.
Once the thought took shape, Gen made a decision immediately.
He removed the character card of Young Uchiha Madara.
[Young Uchiha Madara has been unequipped.]
Then, without hesitation, he equipped Haruno Sakura (Ninja Academy).
Since this wasn't the first time he had equipped the card, there was no recruitment animation, no dramatic sequence.
The change came instantly anyway.
The overall power of his body and chakra dropped by several percent. His physical explosiveness weakened. The quality and volume of chakra both fell slightly.
But along with that, another change appeared—subtle, yet clear.
The feeling of control in his hands shifted.
The chakra became gentler.
Smoother.
Lighter.
As though the sharp edge hidden inside it had been carefully filed down.
"Yes, Lady Tsunade," Gen said, steadying himself.
This time, he made a fresh cut on another part of the rabbit's body, then laid his palm over the wound once more.
Green light flickered.
The flow was still awkward compared to Tsunade's. It lacked that effortless certainty. It lacked speed, stability, refinement.
But this time, it was true medical chakra.
The bleeding slowed.
Then slowed further.
After several minutes of sustained output, the wound margins had already begun to form a visible scab.
Gen exhaled softly.
It worked.
It really worked.
What had seemed like a dead end had split open to reveal another road.
Originally, he had assumed that after digesting most of Sakura's academy-stage knowledge and drawing Young Madara's character card, Sakura's card would only be useful for occasional theory review before eventually gathering dust in his inventory.
He had not expected it to become useful again here of all places.
Tsunade, meanwhile, had been watching without interrupting.
When she saw the result, the slight tension in her expression eased.
So her earlier guess had been wrong.
The problem had not been that he lacked control.
The problem had been something deeper—something tied to the way his chakra naturally leaned.
"Not bad," she said at last. "Your basics are solid, and your chakra control is better than I expected. I can't say yet how far you'll go in the future, but at the very least, learning most foundational medical ninjutsu shouldn't be a problem for you."
Gen lifted his head. "Then I can continue?"
Tsunade gave him a short look, then let out a small snort.
"Of course you can continue. Did you think I'd stop after this much? You're not that fragile."
She picked up the rabbit, checked the wound, then set it back down again.
"But don't get overconfident. Being able to force a hemostatic effect out of your chakra doesn't mean you're a medical ninja yet. It means you've taken one proper step past the doorway. That's all. From here on, the real work starts."
Gen nodded seriously.
Tsunade turned, walked to one of the cabinets, and began taking out several items one by one.
"You'll need to practice with different wound sizes, different depths, different tissue responses, and eventually with moving targets. Then you'll move on to cleansing techniques, treating inflammation, stabilizing fractures, identifying internal bleeding, and basic poison response. If your progress remains stable, I'll add suturing drills, emergency trauma assessment, and chakra consistency exercises."
One bottle after another landed on the table.
"And before you start imagining anything too far ahead," she added, glancing sideways at him, "forget about high-level medical ninjutsu for now. Don't think about Chakra Scalpels, regeneration, organ repair, or combat medicine. Learn how to stop blood, preserve life, and avoid making things worse. That's enough for your level."
"Understood."
Tsunade studied him for another beat.
There was no impatience on his face. No disappointment. No grand ambition leaking through his expression.
Just focus.
That alone made him easier to teach than most adults.
"Good," she said. "Then from tomorrow onward, you'll practice this every day you're free. Record what changes when you switch between different chakra states. Record what fails. Record what succeeds. I want all of it."
Gen's eyes flickered slightly.
So she had noticed after all.
Not the system, of course. Not the character cards. But she had noticed that something about his chakra state had shifted between attempts.
As expected of Tsunade.
Her insight into the body—and into chakra as an extension of the body—was terrifyingly sharp.
Still, she didn't press the issue.
She only cared about the results.
"And one more thing," Tsunade said as she wiped down the instruments. "If you ever use medical ninjutsu on the battlefield in the future, remember this. Healing is not kindness. It's not charity. It's a combat action. You're buying time, preserving strength, protecting resources, and refusing to let your side lose people cheaply. If you think of it as some soft thing meant only for comfort, you'll hesitate when it matters."
Gen's expression grew still.
That line had the weight of war behind it.
"I understand," he said quietly.
Tsunade gave him one last look, then nodded.
"Good. Then today ends here. Clean the table. Feed the rabbit. And after that, go get some rest before Orochimaru works you to death again."
For the first time since entering the room, a faint smile finally rose at the corner of Gen's mouth.
"Yes, Lady Tsunade."