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  • Awesome Music: The anime has some extremely good orchestrated music. A particularly strong example being the church-like song The Polaris which often plays during emotional moments, both joyful and bittersweet.
  • Broken Base:
    • Is the anime too Lighter and Softer and adds in too many recurring characters, or are all the new characters endearing and the anime does the original justice whilst being more appealing to a wider audience?
    • Are the OAV better and more faithful to the source material than the new anime, or are they TOO dark and edgy and remove too much of the goofiness in the manga?
    • Whether Kisaragi Megumi, who is now Kei, should be considered simply a Bifauxnen who still sees herself as a woman, or a Transgender man is very hotly debated.
  • Crossover Ship: And an officially licensed one at that! A Japanese dating service ran an ad campaign in the late 2010s depicting Blackjack going on a blind date with Doronjo of Yatterman fame and hitting it off with her, with later ads depicting the two as a married couple. The theme of the campaign was "encounter beyond your imagination".
  • Fan-Preferred Couple: Black Jack and Kisaragi Kei is the closest thing to one, due to him being the only person Black Jack ever loved.
  • Harsher in Hindsight:
    • One chapter had the author of an extremely popular serial novel close to dying just as he's about to write the last chapter of the story. He winds up dying seconds after finishing the last page. The manga's writer, Osamu Tezuka, purportedly tried to write more manga even on his death bed and railed against the nurse who took his pen and paper away.
    • Artists who die either during or just after their magnum opus show up a lot. Early in the series, there was Go Gan, a painter suffering from radiation poisoning who asks Black Jack to keep him alive long enough to finish his painting of the event that caused it. Tezuka would also die trying to finish one last book for his fans to enjoy. A similar scene showed up in Tenacity that was made all the more heartrending by the fact that Tezuka's Author Avatar is a major character.
    • Almost every one of Pinoko's "comic relief" traits is the direct result of her ultra-creepy/tragic past.
  • Macekre:
    • The dub scripts for the first six OAVs and the movie are sometimes dramatically different from the subtitles. This mostly manifests as an inexplicable rearrangement, alteration or deletion of several key lines, which can sometimes make the dialogue rather clunky. This is particularly evident in the fourth OAV, in which the entire point of the episode is subverted, and in the movie, wherein one character goes from being tragically misguided to downright Satanic, as well as rendering the movie's Green Aesop anvilicious. OAVs 7-10 are mostly exempt from this, fortunately.
    • OAV 1-6 were an unusual case. The Japanese license-owners, having seen Tezuka properties in the past handled very badly indeed, insisted that Central Park Media release Black Jack exactly as they received the materials from Japan. CPM agreed, but were surprised to find the materials included an already-produced English-language dub, and no original Japanese-language track. The Japanese license-owners had actually outsourced the dub on their own. It was not until several years later, when CPM licensed OAV 7-10 and the series was released on DVD, that the original JP track was made available in North America.
  • Misaimed Fandom: Several fans believed that Pinoko being a child-sized adult is considered as "anime logic", before they would eventually find out her tragic past as a teratoid cystoma.
  • Nightmare Fuel: The entirety of "Nadare". An adorable baby deer is subjected to brain surgery in an effort to give it human-level intellect. The result is it becoming an albino, sociopathic and borderline demonic beast that goes around maiming human beings once it reaches adulthood.
  • Values Dissonance:
    • A boy is considered odd for enjoying and being good at feminine things like sewing. He later discovers that as an infant, a doctor saved him from dying of a brain injury by transplanting pieces of a recently-deceased woman's brain to his (though the doctor does say the woman's brain cells ought to have completely merged with his, by the age he is when he learns this).
    • A woman has her uterus and ovaries removed, and lives as a man afterwards due to the fact that "she cannot be a woman anymore" (i.e., give birth and be a mother). A lot of debate has sprung up as to whether Kei/Megumi Kisaragi is a victim of sexist ideology or a bona fide Transgender man.
  • The Woobie:
    • Black Jack himself, although he doesn't let his traumatic history show: when he was a child he was horribly injured by a dud bomb, losing his mother and almost losing his life if not for the efforts of Dr. Honma and his childhood classmate who donated skin grafts to him. Even though he survived, he had to fight tooth and nail to regain use of his limbs during rehabilitation. Since then, he lives in social isolation (except for, eventually, Pinoko) putting up with a bad reputation with most despite his medical mastery.
    • Pinoko is an 18-year-old girl who can never have a normal adult life because she was born as a parasitic cyst in her twin sister. As part of that, she'll never have the love of the man who saved her life because he can only see her as a small child. And to top it off, her real family wants nothing to do with her and her own sister despises her. It's a wonder she can stay so cheerful.

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