It's the early nineteenth century, and young Dr. Noboru Yasumoto has been summoned for a reason unknown to him to rural Koishikawa Medical Clinic from Nagasaki, where he has been stationed for three years completing his internship. The clinic, headed by the outwardly stern Dr. Kyojô Niide - nicknamed "Red Beard" for that attribute - under his very strict guidelines, treats the poor and disadvantaged of the region. Much to his surprise and dismay, Yasumoto is told he is to start work there immediately, staff, including doctors, living on site. As he was expecting a position as a physician for a shogunate in his privilege, Yasumoto shows his displeasure at this fate at every turn. He believes this fate was either orchestrated directly by Red Beard in solely wanting access to his detailed professional notes - Yasumoto believing he a much better doctor than his new, more experienced superior - or by the father of a female acquaintance in an effort to get rid of him. Yasumoto may get a different perspective of life as a doctor at the clinic in getting to view Red Beard's methods first hand, as he gets to know the stories of some of the in-patients at the clinic, and as he is assigned his first patient, Otoyo, a twelve year old orphaned girl who was raised in an abusive brothel environment in an effort to seal her supposed future.