Looking at social problems from a medical point of view, and with that, a scientific point of view and analysis
A short while after entering university I started studying in a university lab. The lab was within the medical faculty and focused on looking at the proper role of medical services in society and social problems related to medicine. They were researching such areas as medical malpractice, lawsuits, side-effects of drugs. That experience was the impetus that made me start thinking about the relationship between medicine and society. The professor who taught me in that lab is now providing me with instruction at the graduate school of Tokyo University.
As I mentioned in Part 1 of this article, the Great East Japan Earthquake occurred when I was in my sixth year of study in the faculty of medicine. Two months after the earthquake I went with a professor from the lab to Iitate Village in Fukushima Prefecture. At first I was concerned because the radiation levels were quite high. Nonetheless, I simply had the feeling that I should do my best and not worry too much about that. My personal radiation dosimeter was constantly ringing but I felt that my first priority was to enter the disaster area.
As a medical student who visited Fukushima Prefecture many times, my impression was that real reconstruction would take quite a long period of time. This led me to the firm conviction that I would like to practice as a doctor in this area. My initial residency was scheduled for a general hospital in Chiba Prefecture. I decided to work in a hospital in Soma City in Fukushima Prefecture immediately after I finished that training and received my medical license.
Many doctors take the step of becoming a medical specialist after obtaining their medical license. However, I decided not to follow that route. At present I don’t have a concrete vision of my future. However, I do feel that I would like to provide medical services to as many people as possible rather than becoming a specialist.
It is true that a medical specialist can utilize cutting-edge technology in order, for example, to save the lives of 10 people. On the other hand, there is also the possibility of providing inexpensive and basic medical care to 100,000 people. I do not want to say that one approach is more important than the other. Rather, I personally feel more attracted to the approach of trying to help 100,000 people. I feel that there is the path that I will follow in the future through my medical work here in Soma City.
For me, developing ideas about how medicine can respond to social problems is crucial. One of those major problems is our aging society in Japan. I would like to address that problem as best I can.
The proportion of senior citizens in Japan is forecast to continue to grow in the future. I believe in the not too distant future there will be one senior citizen for every two young people. When that occurs, the present system will not be able to keep up. There is a need for people and for ideas to deal with that impending situation. At present, rather than “working” at the hospital here in Soma City, you could say that I’m “struggling” here as each day brings difficult challenges to be met. Nonetheless, I firmly believe that what I am learning each day will be of use to Japan when facing the problems that will have to be solved in the near future.
The reason that I decided to remain associated with the graduate school of medicine is because I would like to deepen my learning and because I would like to scientifically analyze the medical services being provided in Soma City. The patients that I see are primarily senior citizens, as the proportion of senior citizens in the area has increased as a result of the disaster. I am interested in learning what is happening in the area, what the needs of the local citizens are, and the best solutions that can be provided. As a doctor, the best thing I can do is provide advice and medical care to those in need.
In addition, I have come to believe that the medical services to local citizens can be further improved by collecting and scientifically analyzing data, records and information about medical care provided in the area. Moreover, this analysis and research will surely be of use to Japan in the future.
The reason why he did not choose to be a specialist
Pursuing medicine at my own pace rather than taking the path to specialization
There is one more reason that I decided not to become a specialist, which is because I want to study medicine at my own pace. A specialist is required to study certain things for a specific number of years. I feel most comfortable with a more personalized learning style where I study until I am satisfied with my degree of learning, and then ask experts about areas that I don’t understand. I want to learn at my own pace and, based on that learning, work with my patients.
I cannot clearly recall when I first felt that I wanted to play a useful role in society, which was my original motivation to become a doctor. I remember the time when the Kobe earthquake happened at the end of my first year of elementary school. That earthquake made a great impression on me because at the time I was living in Osaka, which is very close to Kobe. Afterwards the Kobe area worked hard to make a rapid recovery. As a child I felt vaguely that I wanted to be a person who can help people in such situation.
I was very interested in the outlook and writing of the novelist Ryotaro Shiba and I think his novels also had a significant influence on my future. Shiba wrote historical fiction and portrayed the lives of historical figures that had a great impact on their societies. When I was in junior high school I clearly recall being amazed reading about such great figures of the past.
What does he keep in his mind when he faces the community?
Emphasizing social connections and working to prevent isolation among seniors
The key phrases for my present work are senior citizens’, and care for the elderly. There is a limit to what I alone can achieve with medical exams at the hospital. To overcome those limitations, it is most important that I develop good relations with local citizens. My goal is not solely curing disease. I am also aiming to make hospitals and medical care an interface that will lead to improvements in the lives of local citizens.
That is the theory, although achieving it is not an easy task. I am very concerned about the senior citizens that I see at the hospital. The number of such patients who are unable to leave the hospital is increasing. There are many cases where, in medical terms, the patient is able to leave the hospital, but they cannot because there is no family member at home to provide the necessary support. Full-time care facilities are also full, so there is no option for such patients to leave the hospital. Thankfully, the present mayor of Soma City is also a doctor and he has a good understanding of the situation. A public housing unit, called the Soma Community Center, was built with the objectives of helping senior citizens live independently and reducing the isolation of the senior citizen community.
It will soon be one year since I came to Soma City, and four years since the Great East Japan Earthquake occurred. It can be said that residents of the disaster area have begun to return to their normal lives. On the other hand, many people are becoming quite emotional after having suppressed their feelings for a long period of time and the symptoms of chronic diseases for some are worsening. Therefore, a strong commitment to the community is required from me as a doctor, including my work performing daily health examinations.
I always place a great emphasis on individual interaction. I believe that social relationships among people have a very beneficial effect on health in general. When senior citizens lose social contact with the community, it is easy for them to become isolated. Isolated senior citizens often fall prey to alcoholism and diseases, and they may die at home without anyone noticing. We have to do our best to reduce the number of isolated senior citizens. In order to do that, we must research how entire communities can support senior citizens. We must research the present situation and existing problems, and think about what can be done in the future. Then, we must take action.
I am at the very beginning of my career as a doctor. It is difficult for me, therefore, to talk about my future, but one thing I feel sure about is my desire to gain as much experience as I can in many communities, not limited to areas that have suffered a disaster. But my first mission is to provide consistent support to senior citizens through medical care here in Soma City. Looking ahead, I intend to follow my convictions and strive to help as many people as I can as a doctor.
 | Interviews from the First Part -Meeting the challenges of a disaster in an area with an aging population. |