The Winter 2024 Anime Preview Guide

Doctor Elise: The Royal Lady with the Lamp

Aoi Takamoto was once an evil empress named Elise before being executed by her husband, Linden. When Elise is reincarnated into the modern world as Aoi, she becomes a surgeon to atone for her mistakes. However, after she dies in a plane crash, she is once again reincarnated back into her former life as Elise, 10 years before her execution. She avoids marrying Linden this time around to prevent a tragedy. With her medical knowledge, she decides she wants to become a doctor again in this life.

Doctor Elise: The Royal Lady with the Lamp is based on the Korean web novel Surgeon Elise by author Yuin and illustrator Mini. The anime series is streaming on Crunchyroll on Wednesdays.

One of the quickest ways for one of these modern isekai anime to win me over is to treat the life and experiences of the protagonist's “pre-sekai” life-like something more than an annoying narrative inconvenience to be jettisoned at a moment's notice. What works in the favor of Doctor Elise: The Royal Lady with the Lamp is that this premiere marks the second time that our heroine Aoi/Elise has been isekai'd, which means that both of her previous lives are going to be critical to the new-but-also-old life that she is living in this other-but-actually-her-original world. She started off as the typical villainous tyrant and then life as a regular Japanese lady taught her humility and empathy—not to mention some crackerjack surgical skills. Now she has been reborn as Elise once again—with the only question being whether she'll finally be able to make the most of her life now that she's been given a third shot at doing things over.

This is a similar hook to last season's Tearmoon Empire, which also featured a once-tyrannical empress using the convenience of memory-transferring time displacement to figure out all of the ways that she didn't actually have to be a life-ruining monster—though the difference in Aoi's case is that the good doctor has multiple decades and universes' worth of experience to draw on (and also isn't a complete moron). To be honest, this has got to be my favorite variation of the usual reincarnation shtick because it necessitates that the story feature a protagonist who goes through meaningful conflict and character development. You know, those things that make stories good? Also, I appreciated the medical-drama angle of Elise's life as Aoi, which I hope the show will run with now that all of the backstory is out of the way and she's living life as Elise again in the new world. Ever since I watched Monster, I've realized how long it's been since the anime world has had a solid medical drama and it would be cool if Doctor Elise could fill in that niche.

All that being said, it's worth noting that the show suffers from some drawbacks that will limit its appeal. For one, this premiere doesn't give us much to go on so far as the fantasy world where we will be spending most of our time is concerned, and what brief glimpses we do get paint a fairly generic picture. Speaking of painting pictures: The show isn't all that pretty to look at. You could do far worse, to be sure, but it's definitely one of those anime that constantly makes you think, “Gee, imagine how much more invested I would be if there was anything interesting to look at in this moving-picture show!” I'll probably give the series at least another week or two to see if it can properly grab my attention, but the jury is out for now.

I really like the premise of Doctor Elise. The idea of being reincarnated back into your original body after spending an entire other life in another body is a novel one. It allows Elise, our heroine, to have both knowledge of the modern world and the future of the fantasy world without falling back on the “reincarnated in a game/novel world” storytelling crutch.

Moreover, this allows for great character-building opportunities. Rather than a noblewoman being framed as a villainess or an innocent woman being put in the body of a villainess, the story states that Elise was an actual villainess in her first life. It was only with her death (along with her family's) that she realized what she had done—and truly felt sorry for it.

In what is clearly karmic punishment, she retained her memories in her second life and was denied a loving family in it. Yet, instead of raging at the unfairness of her second life, she set out to atone for her first one—to save as many lives in our world as she ruined in the fantasy one. And even when mortally wounded herself, she works to save everyone she can. However, her reward for this is not absolution or forgiveness. Rather it's only a second chance to do things right.

That's a fantastic setup for a story. However, I'm not sure this episode told it in the best possible way. This episode feels like it should have gone straight from the plane crash to its aftermath and Elise waking up in the fantasy world. All the stuff at the hospital with her coworkers and fans is largely extraneous.

Now, don't get me wrong, I understand why it's in the story—to let us know that Elise is an amazing doctor and that she has truly repented for the actions of her first life. However, it's overkill. The post-crash scene already does both the former and the latter through visual storytelling. We don't need random people we'll never meet again gushing about her skills nor do we need her inner monologue to tell us how sorry she is when her actions in that moment speak for themselves.

TL;DR: Great premise, subpar execution.

Have you ever watched an episode and realized that you really liked it, but have no actual idea why? That's where I am with Doctor Elise, and unfortunately for me, my job relies on my being able to say why I enjoyed it. Was it the fact that it's double-isekai? That even as Aoi Takamoto, Elise desperately yearns for the world of her first life? How she's a superhuman surgeon? All of those things are fine separately, but I think the way they come together makes them work. I'm not sure I've ever seen an isekai heroine who missed her former life quite as much as Elise does, and that adds a layer of pathos to her time as Aoi. She says that she's determined to do better, to save as many people as she can, and she means that which may prove to be the most critical piece of her story.

This is very well-realized in the plane crash scene (which, fair warning, feels pretty vivid). Elise initially appears to have survived, as have most of the passengers in her section of the plane, but we quickly find out that everyone is injured. At first, that doesn't look like it includes our heroine, but as things go on, we see Elise convincing herself that she's fine; in reality, she has a terrible abdominal wound that she's ignoring to fulfill her goal of helping others. On one level, there's some truth to the idea that you're supposed to help yourself before you can aid other people, but Elise has never been about helping herself physically; it appears to be more of a spiritual thing for her. And when she dies after saving one last person, she may have passed some sort of divine test and proved her own reformation, because the next thing she knows, she's back in her previous life. She's just been released from being grounded, so she's already on that downward path, but now she's coming back with all of the knowledge from her time as Aoi – as well as the understanding that she both wants to and has to change the way this timeline plays out.

I appreciate that we don't see much of her first life in this episode. We don't even know what she did, only that she was executed for it, as were her father and at least one brother. It's almost unimportant to know the "why" there, because more pertinent is that she regrets it and has been working to rectify it ever since. I want her to succeed not just because she deserves the chance, but because I've seen her devotion to change. It still feels like we rushed through the prologue (although I suspect we'll get flashbacks as the series continues), and this isn't the best-looking episode of the season (although I'll take CG plane over CG horses any day). But an ineffable something made me want to see more, and that's arguably the most important job of a first episode.

I feel like I should like this one more than I do. In theory, it assuages many of my issues with the villainess substrain of isekai and the general variant. Elise, as a character, has a lot more going on than your typical Isekai Melvin, and her story has nothing to do with video games at all. She's got all the hindsight of Mia from Tearmoon Empire, but also the maturity of an adult. The idea of reliving her original life, but now with the perspective of somebody who's lived a less privileged life and spent years learning to help others, is a great concept. Yet something about this episode didn't click for me the way I wanted, and I'm not entirely sure why.

My best guess is that, as much as this show is trying to be about atonement, it feels more like it's positioning Elise as a martyr. She was executed during a revolution, but we never actually see what she did to earn the ire of the populace – only told that her execution is entirely her fault for her "mistakes," whatever they were. She's instantly and eternally remorseful in her second life, with no hint of having to process or reconsider whatever those mistakes were. Also, she's an orphan nobody has ever loved, and she had no friends until she became a star surgeon who can perform any surgery with a 100% success rate. Instead of dying instantly in the plane crash, she has to die moments after performing emergency surgery on someone with a shard of glass, all while ignoring the enormous, gushing wound in her gut and bleeding out after saving every other person on the plane. It's not enough for Elise to be a dedicated and compassionate doctor – she has to be the world's greatest and most dramatically tragic surgeon ever to wield a scalpel, which makes her far less relatable as a character.

That's a problem because Elise is the only character we know anything about by the end-of-episode twist. Her relations in the modern world are all left behind, and while it's sweet to see how happy she is to return to her family, those characters are totally blank slates to the audience. So the ending isn't so much a shocking twist to hook us into the next episode, but a return to square one where we have to hope the next episode will give us an idea of what the actual show will be like. Elise is the only bridge across that gap, whose defining character trait is that she makes the entire cast of House and ER look like med school dropouts, and that's just not compelling enough on its own.

There's still room for something interesting here, and the premise of bringing modern medical knowledge to a different world is a fun one. Still, the execution of this opening story leaves me with a lot of doubt about the show's ability to capitalize on it.