The whole picture of anxiety and suffering is still unknown to anyone at 18:53 on March 20th.

"Sad or sad" The

veteran emergency doctor who saved many lives was filled with regret.

The unprecedented chemical terrorism in the world, the subway sarin attack.

Many citizens were sown with the deadly poisonous sarin.

But who suffered and what kind of treatment was received?

After that, what kind of anxiety and sequelae do you spend?

Records have not yet been preserved or verified from the victim's perspective.

Why did that happen?

I want to start from that day 26 years ago.

(Reporter, Network News Department, Yasuyo Mabuchi, Commentator, Akira Yamagata)

It turned into a field hospital

It was a quiet morning.

March 20, 1995, Emergency Center of St. Luke's International Hospital in Chuo-ku, Tokyo.

On that day, Dr. Shinichi Ishimatsu, who was in charge of the site, was about to start work in an emergency outpatient department without patients.

The phone from the fire department rang.

The clock on the other side of the nurse who picked up the phone was pointing at 8:16 am.

"It seems that an explosion and fire broke out at Kayabacho Station on the Hibiya Subway Line."

Soon after, patients complaining of eye pain and suffocation began to visit the emergency department one after another.

Ambulance also arrived.

A member said, "A lot of people are lying outside the station," and immediately returned to the scene.

And patients with cardiopulmonary arrest were transported one after another.

Something unusual is happening.

The usual medical treatment was stopped, and the in-hospital broadcast requested support from the emergency center.

Eventually, the hospital was flooded with people who came to seek help on their own and patients who were transported.

The number exceeded 600.

Patients lay in the outpatient settees of each department as well as the emergency outpatient department, and doctors and nurses provided first aid such as intravenous drip.

The chapel of the hospital was also opened to secure a place for the treated people to receive medical treatment.

The situation was the field hospital itself.

“What's happening?”

The patients are not injured.

It doesn't smell burnt.

I knew it was unlikely to be an explosion.

However, all the patients had their pupils shrunk.

Dr. Ishimatsu suspected organophosphorus pesticide poisoning.

However, it is not possible for multiple passengers to drink pesticides at the same time on the subway.

I had no choice but to continue first aid without knowing the cause.

A doctor dispatched from the Self-Defense Forces has arrived.

The materials I brought also included a cure for sarin.

Sarin is the same organophosphorus compound.

... is it sarin?

It is a chemical weapon developed in Nazi Germany.

If it is correct, there is no time to get lost.

The document stated that an antidote called "PAM" would work.

However, even with organophosphorus compounds, administration of PAM to patients with pesticide poisoning may temporarily worsen the symptoms.

Dr. Ishimatsu was at a loss.

"A ray of light in the dark night"

Around the same time, a phone call was made to St. Luke's International Hospital.

It was from Shinshu University Hospital in Matsumoto City, Nagano Prefecture.

Shinshu University had the experience of treating victims in the Matsumoto Sarin case the previous year (1994).

The hospital director at the time watched the victims of the subway sarin incident on television and was convinced that sarin was used again.

I instructed the doctor to call the hospital in Tokyo, where the patient was supposed to have been transported, from one end and said, "I think it's sarin."

At hand, I had a galley of the report of the Matsumoto Sarin case that had just been printed.

The part that summarizes the symptoms and treatment methods of the victims who smoked sarin and the subsequent course was extracted and sent to hospitals in Tokyo one after another by fax.

The number reached about 30 places.

Information that it was sarin was also transmitted to St. Luke's International Hospital in Tokyo.

Materials from the Self-Defense Forces and information from Shinshu University.

Dr. Ishimatsu decided to use PAM in a well-prepared ICU = intensive care unit.

Then the doctor in charge shouted.

"The cramps have stopped. PAM has worked!" The

decision was correct.

Dr. Ishimatsu looks back on this.

Dr. Shinichi Ishimatsu

"I'm worried that I could have decided to administer PAM without information from Shinshu University. It's like" a ray of light in the dark night. "I feel that there are people who support me from behind. It helped me. "

"Forgotten" victims

Later, it turns out that it was Aleph, led by Shoko Asahara and his real name, Tomitsuo Matsumoto, who sprinkled sarin on the subway.

There were 14 dead and 6,300 victims.

An indiscriminate terrorist attack unlike any other in the world, aimed at the capital of the nation.

Former Aleph executives, including former convict on death row Matsumoto, were subsequently sentenced to death and executed in 2018.

Various things were revealed in a public court regarding the "perpetrator."

Terrorism countermeasures and relief systems have also been reviewed.

However, the case has not been verified from the perspective of the "victim."

At the time of the incident, the whole picture of where, who suffered what kind of damage, and how they spent after that is still unknown.

First of all, the victim's medical record.

Changes in firefighting records and health status.

More than 20 years have passed without any public movement to put together or analyze such records.

Dr. Ishimatsu's words at the beginning lamented the situation.

Dr. Shinichi Ishimatsu

"How many patients were there in total, including other hospitals, and what percentage of people had what kind of symptoms? Did the symptoms differ depending on the train you were on? Who are you spending now? I don't even know

“Preventing the same damage” In Matsumoto City

In contrast, the case of Sarin Matsumoto.

Eight people were killed and more than 140 were damaged.

In the same way, the damage was caused by sarin, which was indiscriminately sown, but immediately after the incident, medical institutions collaborated to collect medical records and other medical records and complete them into a report.

The report also includes specific cases.

Where did each victim suffer?

What kind of treatment did you receive, when did you die, or did you recover?

I was able to bring the information to the hospital in Tokyo promptly because I had the report at hand.

Why was it possible?

We interviewed Shinshu University officials at the time.

According to one of them, Dr. Hiroshi Okudera, who was in charge of emergency, immediately after the incident, doctors need to keep a record as a person facing an abnormal situation and use it the next time the same thing happens. He thought there was.

Since it was a limited area of ​​Matsumoto City, it was also great that the university, the local medical association, and the person in charge of the administration had a "face-to-face relationship" and Matsumoto City immediately came up with a support policy such as the burden of expenses.

In Matsumoto City, questionnaire surveys and health examinations were conducted after that, and support for the victims continued.

In addition, Dr. Okudera had a stronger motivation to "do not want to repeat the same damage" as an individual.

An employee of a pharmaceutical company I knew and a college student who was a student at a university hospital died in the Sarin Matsumoto case.

Coincidentally, March 20th, when the Sarin subway incident occurred, was the day of the graduation ceremony when the deceased student was supposed to take the first step as a doctor after finishing his studies at university.

Dr. Okudera is still very impressed with that.

The determination of the doctors who lost their companions to "prevent the same damage" has come to fruition at many life-saving sites in Tokyo.

Dr. Hiroshi Okudera

"There was a doctor's good sense that I should make a report, but since I lost someone close to me, I got a stronger motivation and decided to make anything."

The reality of Tokyo that doesn't move anywhere

Why wasn't it possible in Tokyo to put together a record of treatment and grasp the situation of each victim like in Matsumoto City?

When we interviewed the people concerned, they agreed that the scale of the incident was different.

There are nearly 40 hospitals where patients are transported, both public and private.

It's seven times that of Matsumoto City.

The medical records alone are enormous, but in order to check where, who was damaged, and how, materials that span multiple organizations, such as firefighting and SDF activity records, police damage reports, and subway operation records, are used. Must be collected and analyzed.

It might have been possible if somewhere had taken the lead early after the incident.

However, in reality, no public institution worked.

Records are distributed to each organization and remain unutilized.

Lost records, widespread impact

Record of damage.

Private sector efforts are also underway in Tokyo.

The NPO "Recovery Support Center," in which Dr. Ishimatsu is also involved, conducts health examinations once a year for some victims.

However, more than 1000 people have contact information.

Some people suffer from sequelae.

A man in his 60s still feels pain in his eyes and poor vision.

Symptoms are said to be especially strong at the turn of the season and when tired.

Such upsets are not uncommon, but it is not possible to grasp the situation of people who do not know their contact information.

The medical record is also lost.

The storage period required by law is 5 years.

Some medical institutions have already abandoned it.

A general hospital in Tokyo that responded to our interview said that it had been kept for a long time, but it was all abandoned several years ago due to the rebuilding of the building.

The person in charge said, "If there was guidance from the government to leave it, I considered leaving it."

Shouldn't the country move after all?

Dr. Shinichi Ishimatsu

"Victims have been forgotten by the world and there is no way to be saved. That is what I find painful now."

"last chance"

If nothing is done, the record will be completely dissipated.

However, it was not until I came here that there was a move to preserve the records that were left behind.

"Aleph Parliamentary League" created by bipartisan parliamentarians.

One day, Dr. Ishimatsu, who attended the meeting with the victim, complained of a strong sense of crisis.

In July 2019, the parliamentary group, who knew the actual situation, resolved to comprehensively preserve the records held by the victims' medical records and related organizations, and requested the government.

In response to this, the Ministry of Health, Labor and Welfare set up a research group last year and started research and research to preserve and utilize the records at that time.

The centerpiece was Dr. Toru Okumura, who was working at St. Luke's International Hospital at that time.

That day, he shouted to Dr. Ishimatsu, "PAM, it worked!"

Where and what kind of records are left?

When I started to investigate, I found that six medical institutions, including St. Luke's International Hospital, had medical records left.

Furthermore, it was found that some records of related organizations such as fire departments and police, which were the first actions, remain.

On the other hand, issues have become clear.

In the future, if the medical record information is to be used in any way, the consent of the person or family must be obtained.

It takes time and manpower.

In addition, many of the records stored by related organizations, such as emergency transport records, are treated as "non-disclosure" under the Information Disclosure Law, and there are legal issues.

Still, if it doesn't move now, the records will be further dissipated, and the memories of those involved in the incident will be further diminished.

Dr. Okumura will proceed with research on methods for collecting and storing records that span related organizations.

Right now is the "last chance".

Eventually, when technological innovation progresses, we would like to make it possible to utilize the data of the Sarin subway incident and create a system to prevent the damage from spreading.

A sense of mission for the next generation is driving Dr. Okumura.

Dr. Toru Okumura

"I will not return what I lost, but I think it is my responsibility to keep records and lessons for the next generation. The victims and those who know the time are aging and young people who do not know the incident. The number of generations is increasing. It is extremely important to keep track of how the people involved responded in order to convey an unprecedented event to posterity. "

“For the future society”

Dr. Ishimatsu has been watching over the victims of the Sarin subway incident and advocating the importance of keeping records.

I think it is important to tell many people about the victims.

Dr. Shinichi Ishimatsu

"One of the causes of suffering for victims is indifference. I think that is because I do not know the actual situation of the damage. It is necessary to continue to convey the reality that there are people who have suffered such damage in some way. Yes. It's too late, but it's still the first step for the country to move. It'll be even more late in a year or two, so I'd like you to move on here. "

The case must not be weathered.

It's a phrase we often use, but its ultimate purpose is to never repeat it.

To that end, the importance of communicating, keeping records, and utilizing the incident must be widely understood.

And this time, I would like the country to take the initiative and establish a new system and system to collect and store records so that the victims will not be left behind again.

Network news department reporter

Ashiro Mabuchi

2005 joined

through and judicial representatives in the society section

incumbent from 2020

Commentator

Akira Yamagata

Joined in 1998

After working in charge of justice in the Social Affairs Department, he has

been in his current position since 2020.