Sekiro Surgeon Quest Guide

Fromsoftware’s 2019 hit Sekiro: Shadows Die Twice made some unique adjustments to the studio’s typical Dark Souls formula. While the role-playing elements have been downplayed in favor of a more action-focused combat system, many of the studio’s familiar features are still within the game. One aspect that longtime fans of FromSoft games will appreciate is optional side quests. One of Sekiro‘s most confusing sidequests is that of Doujun, the surgeon. While players have the opportunity to meet Doujun earlier in the game, you’ll only engage with this questline when you are about two thirds of the way through the game’s core content. In this guide, I’ll teach you how to ace the quest step by step and detail the rewards you get from seeing it to completion.

Doujun Quick Facts

  • Location: Doujun can be located in the Abandoned Dungeon, which players can reach via Ashina Castle.
  • Pre-Requisites: You’ll need to defeat the game’s first boss Gyoubu Oniwa before reaching the Abandoned Dungeon and beginning the questline.
  • Quest LengthAbout half to two-thirds of the main game length.
  • Rewards: Upon completing the quest, you receive the Academics’ Red Lump and a regular Red Lump. You’ll also receive three Lumps of Fat Wax upon sending Doujun a subject to experiment on.
  • Voiced By: Fred Tatasciore (English) and an unknown actor for the Japanese dub.
  • Additional Tidbits: Doujun used to study medicine with Emma and was most likely a former monk at Senpou Temple.

How to Find Doujun

Decaying Inmate
The horrors that await you inside the Abandoned Dungeon. Image from Fandom

Upon defeating Gyoubu Oniwa, you’ll now be able to explore the Ashina Castle. You’ll want to do this, as the Ashina Castle is somewhat like a central hub for the game. You’ll be able to find pathways to lots of different areas and side content that will reward you well for your exploratory efforts. To find the Abandoned Dungeon, spawn at the brand new Sculptors Idol at the castle and look for a bridge with an older woman standing on it. Once you locate her and the bridge, pan the camera, and you’ll discover a new grapple point.

Once you find the point follow the path, and you’ll eventually be led to the entry point for the Abandoned Dungeon. The Abandoned Dungeon has been used as an experiment zone for corrupt surgeons of Ashina to perform on subjects. As such, you’ll have to face aggressive Test Subject enemies and giant crickets. Thankfully, neither one of these foes is too difficult to defeat. Test Subjects generally require being killed twice to die fully, but you can cheat that by using your Flame Vent on them. By doing so, you’ll incinerate them, and they won’t be able to resurrect. Once you’re in the Abandoned Dungeon, stick to the left, and you’ll soon run into Doujun. Upon talking to him, he’ll ask you if you want to assist him with his research. If you agree, he’ll give you the Surgeon’s Bloody Letter.

How To Find Doujun Surgeon Quest Sekiro
Doujun stands beside his fallen test subjects. Image from Fandom.

The letter is from Dousaku, Doujuns master, and states that a single tough man is required for the experiment. Preferably a samurai or a larger-built man like those from the Taro Troup. Fortunately, you’ll meet two different NPCs you can send. One is Kotaro, the monk, or Jinzaemon, the samurai. The ending of the quest and the rewards don’t change depending on the NPC you dispatch to Doujun, so that part is entirely up to you and your judgment.

Giving the Bloody Letter to Kotaro

Kotaro Surgeon Quest Sekiro
Poor Kotaro. He deserves better / Image from Fandom

Kotaro is a monk who can be found close to the Senpou Temple Sculptor’s Idol. Once you discover the idol, head down and make a right, and you’ll find him sitting and crying near a tree. Kotaro is a gentle giant with a crestfallen nature, and he’ll lament losing the location of several children he used to travel with.

Once you talk to him, he’ll mention that he has a pounding headache and is searching for a pure white flower. Unlike the other monks of the Senpou temple, he is not hostile to you and will not attack you. You won’t be able to give him the letter immediately and will instead have to bring him the Red and White Pinwheel to progress Doujun’s questline further.

Finding the Red and White Pinwheel

Red And White Pinwheel Surgeon Quest Sekiro
The elusive Pinwheel’s location / Image from Fandom

Thankfully, you’re in the right area to locate the Red and White Pinwheel. You’ll want to progress through Senpou Temple right before you reach the halfway point and have to challenge the Armored Warrior mini-boss.

Senpou Temple is not the easiest location to traverse, especially with the Monks that guard it. Senpou Monks fight with a deadly hand-to-hand style and travel in groups, making them much deadlier. The temple is also home to other enemies as well. Fortunately, the temple is relatively linear, and it’s not too difficult to stick to the right path. When facing monks, you’ll want to use stealth to your advantage and pick them off one by one whenever possible. If you’re not feeling confident in your combat abilities, you can also use your grappling hook and the trees to stay out of their line of sight.

Once you locate the Shugendo Sculptor’s Idol, you’ve reached the right place. Instead of heading to the bridge that triggers the Armored Warrior fight, look around for a cliff full of red statues and pick a Red and White Pinwheel for Kotaro. Once you retrieve it, spawn back at the Senpou Idol and pay our friend a visit.

Once you deliver the Pinwheel to Kotaru, he’ll lament the situation and say you brought him the wrong flower, but don’t be deterred. Speak to him again, and you’ll get the option of sending him to Doujun. Once you send him to the surgeon, spawn at the Abandoned Dungeon Sculptor’s Idol and speak to Doujun again to trigger the next part of the quest.

Giving the Bloody Letter to Jinzaemon Kumano

Jinzaemon Kumano Surgeon Quest Sekiro
The dutiful Jinzaemon Kumano. Image from Fandom.

Another option for securing a good test subject for Doujun is the samurai, Jinzaemon Kumano. We first meet Jinzaemon very early in the game. He can be found in the Ashina Reservoir, right on top of the underground area where you can fight the Lone Shadow Longswordsman. While Jinzaemon has his own questline outside Doujun’s (as does Kotaro), for this guide, we’ll focus on only progressing Doujun’s questline.

Thankfully, Jinzaemon requires much less legwork to be recruited as a test subject than Kotaro. All you need to do is receive the Surgeon’s Bloody Letter BEFORE you talk to him. If you run into Jinzaemon earlier and converse with him, you’ll be locked out of this step as his quest line will begin. Once you have the letter in hand, initiate a conversation with him, and you’ll be prompted with the choice to send him Doujun’s way.

After you send the samurai to the surgeon, you’ll want to report back to the Abandoned Dungeon and begin the next steps in the questline.

The Final Phase of the Questline

Obtaining the Surgeon’s Stained Letter

Upon returning to the Abandoned Dungeon, you’ll want to rest at the Sculptor’s Idol a few times to let a sufficient amount of time pass. After two or three rests, you should be able to speak with Doujun and begin the next phase of the quest. Once you’ve unlocked the new dialogue options, Doujun will give you the Surgeon’s Stained Letter. This letter instructs you to kill and deliver the glowing red eyes of a Treasure Carp in Mibu Village.

To kill the carp, you’ll need the Mibu Breathing technique, which can be unlocked by defeating the Corrupted Monk. Fortunately, the Corrupted Monk is mostly a pushover, with many players able to cheese him by spamming him with Fistfulls of Ash. For what it’s worth, the Corrupted Monk was one of the few bosses I could take out on my first try during my initial playthrough. Check our guide linked above if you want additional details on that encounter.

Making Your Way to Mibu Village

Mibu Village Surgeon Quest Sekiro
You’re at the right place when you’ve reached the Water Mill. Image from Fandom

To locate Mibu Village, you’ll first have to explore the Ashina Depths. The Ashina Depths can be found via two different pathways, the first requiring further exploration into the Abandoned Dungeon. Eventually, you’ll find a deep hole to jump down, and when you do, you’ll land in the depths. The alternative pathway needs exploration of the Sunken Pathway and the successful evasion of the Great Serpent encounter. You’re free to choose either path, but in my opinion, if you’re already in the Abandoned Dungeon, then it would be a more efficient use of time to take advantage of its pathway to the Ashina Depths and Mibu Village.

Once you find yourself in Mibu Village, you’ll realize that all is not well. The village is full of undead enemies who resurrect themselves and will try to overwhelm the player in sheer numbers. Fortunately, their health is pretty low. Mibu Village is an excellent location to farm experience and currency, so don’t hesitate to let yourself off the beaten path and grind away to strengthen yourself further.

Like many locations in Sekiro, its path is pretty linear, and the road to the Corrupted Monk is primarily a straight shot. Once you’ve discovered the Water Mill Sculptor’s Idol, you’re almost at his location. Before facing the Corrupted Monk, you’ll also notice a crying woman NPC. Be warned; If you speak to her, you’ll also have to fight Orin of the Water, who, in my opinion, is much more challenging than the monk.

After defeating the Corrupted Monk, you’ll unlock the Mibu Breathing technique, which allows you to breathe underwater. With this essential technique at your disposal, you can locate and kill the Red-Eyed Carp and move on to the final steps of Doujun’s questline.

Killing the Carp

Thankfully, the carp is pretty easy to locate. Once you get the Mibu Breathing technique, you’ll want to spawn at the Mibu Village Sculptor’s Idol and head straight. Dodge the enemies in your way and seek out the pond; once you find it, dive in. You’ll quickly realize the pond is far deeper and more expansive than it initially lets on, but the elusive carp’s red eyes make it extremely easy to locate.

Most of the time, the carp can be found by swimming straight away toward a deeper groove in the water; you should see a group of about 3-4 carps, including one with red eyes. Underwater dash towards them and swing your sword, and you should eliminate the carps in one fell swoop. Upon doing so, you may also receive Treasure Carp Scales, and you’ll definitely receive the Red Carp Eyes.

Delivering the Red Carp Eyes

Once you’ve got the Red Carp Eyes in hand, spawn at the Abandoned Dungeon Sculptor’s Idol and head to Doujun, who will be in his usual location. Talk to the surgeon and deliver the eyes to him, and he’ll reward you with three Lumps of Grave Wax, which can be used to upgrade your prosthetics. After he gives you the wax, return to the Sculptor’s Idol and rest. Then head back to Doujun’s location.

Once you’re there, you’ll eavesdrop on a conversation between him and his master, Dousaku. Dousaku will tell Doujun that he’s “strayed too far from the path of medicine” and that the surgeon is now the subject of the following experiment. After listening in on their conversation, dive into the waters of the Abandoned Dungeon and follow the path of the waterway; once you’re out of the water, jump up, and you’ll make your way to Doujun’s room only to find him alone in there, begging to Dousako and asking you to leave. Before you depart, be sure to open the door in Doujun’s lab.

The Final Step

Jinzaemon In Surgery Surgeon Quest Sekiro
Jinzaemon undergoing Doujun’s surgery. Image from Fandom.

After you’ve eavesdropped on Doujun and Dosaku, rest at the nearby Sculptor’s Idol and make your way back towards Doujun’s location. You’ll find Doujun with glaring red eyes and Jinzaemon or Kotaro with a matching pair of red eyes. Jinzaemon is the more challenging of the two and will attack you with fast and thunderous sword swings, while Kotaro wields a giant bell that can present its difficulties due to the narrow space of the arena.

Doujun fights with a hand-to-hand combat style similar to the Senpou Monk enemies. If you picked Kotaro as your subject, it’s possible to sneak up on him and deliver a Death Blow that will take him out of the equation, and in a one-on-one fight between you and Doujun, you’ll find that the surgeon won’t be victorious. Regardless of which subject you fight, I recommend using your Shinobi Fireworks to get the drop on them and using your sword to chip away at their vitality and posture meters.

Like all enemies with red eyes, they are terrified of flames, so don’t hesitate to unleash your Flame Vent on them. After you defeat Doujun, he’ll apologize to his master, and you’ll be rewarded with a regular Red Lump and the Academics’ Red Lump. Once you get the lump, the quest is complete, and your work is done.


Question: Does it matter if I send Kotaro or Jinzaemon to Doujun?

Answer: Not necessarily. Both are perfectly good test subjects and will allow the quest to proceed as planned. The main question you should ask yourself is, which character are you more invested in? Jinzaemon and Kotaro have other questlines you can choose to proceed with, and they both reward you in different ways. I preferred Kotaro’s questline to Jinzaemon’s, but Kotaro is also easier to defeat than Jinzaemon, so ultimately, that choice is for you to make. FromSoftware encourages replayability and New Game+ playthroughs in their games, so view this questline as another avenue to explore on a subsequent playthrough and embrace both options.

Question: Are Doujun and Dousaku the same person?

Answer: As we know it, yes. It’s safe to assume that Dousaku was a real person at some point. Still, in Doujun’s quest to procure immortality, he lost his sanity and hallucinated his continued existence. The world of Sekiro is dark, and throughout your adventure, you’ll interact with multiple characters who have lost their way and sanity upon drinking corrupted waters. Doujun is a symptom of the problems that plague Ashina, not the proverbial disease in and of itself.

Question: What’s the point of the Academics’ Red Lump, and why should I complete this quest?

Answer: While the Academics’ Red Lump can come in handy for reducing your posture damage at the expense of losing the power to resurrect yourself, the reward for this quest isn’t so much material. Instead, it’s the way it dramatically expands on the universe of Sekiro and perfectly compliments FromSoftware’s existing body of work. Sekiro is a game that explores themes of greed, the pursuit of power, and the desire to be immortal, and it shows how those desires, when warped, will corrupt a person into a pale imitation of their former self. Several other characters mirror Doujun’s descent into insanity throughout Sekiro‘s events. Ultimately, you’re not doing the “right” thing, so your material reward shouldn’t be particularly significant. Instead, the prize is further exploring the game’s themes and seeing the full spectrum of FromSoftware’s artistic vision.


Sekiro: Shadows Die Twice is not a particularly optimistic game. It’s a dark and twisted tale of power, betrayal, and the lengths people will go to when only concerned for their bottom line. As Wolf, you make several choices throughout your adventure that can dramatically alter the outcome of the game and the universe in which it takes place. If you choose to walk on the dark side and assist the twisted surgeon Doujun, you will find yourself with little to show for it.

However, the reason that FromSoftware puts so many side quests into their games and encourages new playthroughs is that you, the player, can fully explore their worlds and embrace the full spectrum they have created. If you want to see everything Sekiro offers and walk away from it with the most nuanced understanding of the lore, then you owe it to yourself to aid the surgeon at least once. It can be a confusing side quest, but with our guide at your side, you’ll be able to see it through with no problem.

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