I'm sorry if I did my best, 7 years of regret Doctor goes to the bereaved family April 4 26:20
I had been with him for more than three hours.
But those three hours changed my life.
A doctor who has been regretting for seven years.
Parents who want to know the truth.
"We will never waste that experience,"
said the doctor who met him for the first time.
(Network News Department Reporter Souya Sugimoto, Chiba Broadcasting Station Shintaro Sakurai, Good Morning Japan Soichiro Nagao)
He had a dream
Karin Miyazaki, who lived in Koshi City, Kumamoto Prefecture, was an active girl.
I was a 4-year-old who loved to ride on swings and couldn't help but want to run around the park.
His special skill is drawing. I often drew my favorite princess characters with crayons.
Karin had a dream.
Wearing a uniform to kindergarten and playing a lot with my older sister, who is two years older.
Carrying a shiny school bag to elementary school.
I was staring at the school bag my sister had just bought.
But that dream didn't come true.
Karin died at the age of four.
There are signs of recovery...
Karin had a congenital heart condition.
"Complete atrioventricular core defect"
It was difficult to treat radically, and I usually inhaled oxygen and medication 24 hours a day.
I decided to live with the disease for the rest of my life and had major surgery at the end of January 2016.
The operation seemed to go well.
However, his condition after surgery was not stable, and he was traveling back and forth between the intensive care unit (ICU) and the general ward until April for follow-up.
He was on a ventilator, was given a large dose of medication, and was told that bed rest was an absolute requirement.
At one point, there were signs of recovery.
Two major earthquakes hit there, the 4 Kumamoto earthquake.
Karin was not injured, but after the second earthquake in the wee hours of the morning, her parents were told by doctors:
"Please accept the transfer because the hospital may collapse,"
the aftershocks continued in the ICU. Every time she swayed, her mother, Sakura, covered the sleeping Karin over and over again.
Although she had no choice but to accept the transfer policy, Karin was required to rest at a hospital in Fukuoka Prefecture, about 2 kilometers away. It took two and a half hours even in an ambulance vehicle.
Sakura and her family chased after them with their cars. After the earthquake, the road surface was broken and there were traffic jams.
It wasn't until more than four hours later that I was finally able to see Karin again in the hospital room where I was transferred.
Her mother, Sakura, said,
"Why is the hospital that is supposed to be the safest... What. I was doing my best at treatment, but when I met him again at the transfer destination, the oxygen saturation value was 70, which was so low that I had never seen it ... Perhaps because of the fact that I stopped dialysis, my face became swollen and I didn't have a trace of it anymore."
Five days later, Karin passed away. Later, it was recognized as a "disaster-related death" due to the suspension of the hospital function and the burden of transfer.
I was the one who led the transfer transfer.
Dr. Tatsuo Takama of
Kagoshima City Hospital was one of the people who led the transfer of Karin.
Dr. Takama usually works as an emergency physician and has accumulated experience as a disaster medical dispatch team "DMAT".
At 2016:4 p.m. on April 14, 21, when the first earthquake with a seismic intensity of 26 occurred in the Kumamoto region, I received a request from the Ministry of Health, Labour and Welfare to Kumamoto from the hospital in Kitakyushu City, where I worked at the time.
In some hospitals, lifelines were cut off. While there was a risk of building collapse, we evacuated to the hospital, in which patients were transferred and discharged all at once to ensure that treatment would not be interrupted. There was also a large-scale operation that evacuated nearly 7 people.
But it didn't end there.
April 4, 16:1 a.m.
Later, it was called the "main shock" and a tremor with a magnitude of 25.7 observed on the same scale as the Great Hanshin-Awaji Earthquake struck. Dr. Takama was about to transport a patient from the hospital.
When the evacuation at that hospital was completed, in the early morning of the 3th, the next destination was Kumamoto City Hospital, where Karin was located.
The Last Girl Left
When I went there, the hospital was in trouble.
Countless cracks in the building. Many windows were broken, water was leaking from water pipes, and water was falling from the ceiling of the first floor.
I found out later that some of the wards of the former Kumamoto City Hospital did not meet earthquake resistance standards.
Preparation for the evacuation of all more than 300 patients.
Dr. Takama and DMAT were assigned to direct the wide-area transportation of 13 people, including newborns in the NICU, pregnant women with threatened premature birth, and the most severe children, to outside the prefecture.
In cooperation with the fire department and hospitals throughout Kyushu, and some helicopters were used to transport the evacuation, the evacuation seemed to have progressed smoothly in general.
However, there was a child who was left alone at the end.
It was Karin-chan.
In the ICU, every time a big aftershock came, a woman who looked like a mother would take a position to cover Hanari.
We have to do something about it as soon as possible...
However, the transport vehicle cannot be found. The problem was Karin's condition and accompanying medical equipment.
Karin, who had severe pneumonia, was connected to a ventilator and 10 electric medication devices called syringe pumps.
There is not enough space in a very normal ambulance. It is not possible to secure a power supply battery for 10 devices.
It was judged that the air pressure drops as the altitude rises with a helicopter, putting a strain on the body, and that there is no space for a large amount of equipment.
It was difficult to arrange a vehicle in the chaos, and after making a phone call from one end to the other, I managed to find a supporting doctor car.
I unloaded my seats, luggage, and anything else I could unload, and when I finally loaded the equipment with Karin and left, it had been 9 hours since the big shaking.
Was that "the best"?
After learning that Karin had passed away, Dr. Takama repeatedly asked herself questions.
"Was that child really not able to be transported by helicopter?"
he gradually couldn't ignore his thoughts, and Dr. Takama decided to quit the hospital in Kitakyushu City where he worked.
It was to move to a hospital in Kagoshima that operates doctor helicopters on a daily basis.
新たな職場では、県内各地の離島や山間部などから、1日4、5件のヘリ搬送がありました。
航空医療が日常と隣り合わせの奄美大島の県立病院でも、2年間の経験を積みました。
教科書には答えが書かれていない実践の世界。
花梨ちゃんの搬送で取り得た選択肢を求め、数々の機体に乗り込みました。
「当時、ドクターヘリなら狭くて彼女は乗らなかった。じゃあ多くの医療機器をつないだままでも運べる陸上自衛隊のヘリなら？」
「これならあのシリンジポンプ10台でも収まるか…」
ヘリコプターはパイロットとの交渉しだいでは、高度を下げたり上げたりすることができるということも分かってきました。
機材を減らして運ぶ方法も考えられるようになりました。
個別のヘリコプターの性能、要請の仕方や運用システムを熟知しなければ、適切な判断ができないことも見えてきました。
ふだんはしない対話の理由
この7年間で、高間医師は航空機医療のプロフェッショナルとなり、今や後進を育てる立場にもなりました。
ただ、ある行き詰まりを感じてきました。
「災害医療はだんだんリアリティがなくなる」
時間が経つごとに、当時の思いが薄らいでしまうのです。
そんなとき、高間医師が目にしたのは、新聞に載った花梨ちゃんの両親の姿でした。「安全で災害に強い病院をつくってほしい」と訴えていました。
高間医師は、ある決心をしました。
「通常、亡くなった患者のご家族に後になって会うことはないんです」
高間医師は熊本駅から車に乗っていました。向かった先は花梨ちゃんの自宅でした。
この7年間の取り組みの原点に向き合いたいと、両親と連絡先を聞き、初めての訪問でした。
高間医師
「自分がうまくいかなかったことに向き合うのは、勇気はいりますね…正直、なに言われるんだろうとか、いろいろどきどきはします。だけど、“会ってもよいですよ”とおっしゃっていただいたので、まずはあのときのことを謝って、それからこれまでのことを話そうと思います」
7年越しの邂逅
熊本県合志市の花梨ちゃんの自宅。
高間医師は、母親のさくらさんと父親の貴士さんに出迎えられました。
「ちょっと緊張しておりますが、仏壇にご挨拶させていただいてよろしいでしょうか？」
花梨ちゃんの仏壇を前に手を合わせた後、高間医師はこう切り出しました。
高間医師
本当にうまくできたかって言われると、いろんな反省点とか、ああできたんじゃないか、こうできたんじゃないかというのが今でもあるんです。
ヘリ搬送はできなかったのかと思いまして、7年間近く航空医療をやってきましたが、まだまだだなと。今回お会いさせていただいて、仏壇に手を合わせて、もう1回原点に返りたいと思いまして…
高間医師は少し言葉を詰まらせると、母親のさくらさんから声を掛けられました。
さくらさん
こんな風に時間が経ってしまいましたけど、あの時は搬送していただいて本当にありがとうございました。私たちは先生がいたからこそ福岡に運んでいただいたと思っています。まずはとにかくお礼を今日は伝えないといけないと思いまして。
After being told that, Dr. Takama coughed up and talked about what had happened so far.
Dr.
Takama actually took a jet of a seriously ill patient to Sapporo yesterday. Like Karin, she also had a ventilator. Without the Kumamoto earthquake, we wouldn't be able to carry it as we do now.
We do emergency medicine every day, but in disaster medicine, patients are not in front of us right now. Constantly training, training. But when it comes to disaster, the situation will be far more than that. We always have to be prepared, but after seven years, it's hard to feel that real scene... There was a part of me that was very scared that it would gradually fade away.
I tell young people in their 7s and 20s about Karin. Transporting one person means that we should do the best we can right now, and that disasters will inevitably come, so let's think we are professionals. I wondered if I could follow her will and move forward even a little. I'm sorry, I couldn't talk about it like this...
I told my parents that I had repeatedly shared Karin's story over the past seven years.
I thought that if possible, we would relive Dr.
Takama's transportation of Karin-chan together, and we would definitely make use of it next time, so we have been training so far. On the island of Amami, we also transported patients with severe coronavirus, but I always thought it was a disaster drill. When I put my hands together earlier, I thought it would be nice if Karin could tell that I did this kind of training.
For us, too, it was the Kumamoto earthquake, and we really have to examine each and every one of them. What was it made of and why couldn't it be done? I'm sure there will be a Nankai Trough or a bigger disaster next. If the time comes, what can I do to save more and more people?
"For doing your best."
Despite occasional reluctance, Dr. Takama continued to speak.
Hearing these words, her mother, Sakura, was in tears.
And I told him my true feelings at the time.
Sakura-san
DMAT said, "I've never carried a child in such a state." When I heard that, I thought that even the slightest change was so difficult to transport. That's why I thought maybe I couldn't do it and would be abandoned. But they carried it properly...
His father, Takashi, also spoke to me.
Mr.
Kishi, I really think that I really "did my best" in that state, so I hope that the experience of that time will live on in the future.
Dr. Takama replied:
Dr. Takama's
father just told us that he did his best, but from here on, it is our problem, and we will never be able to just say "we did our best."
I tried my best, but it didn't work out. I tried my best, but I couldn't. In order to take another step forward, you absolutely have to face it, and you have to gain something from it. I think this applies to all types of medical care.
Karin is there
About an hour and a half after the visit, my mother, Sakura, gave me something.
"I made a lot of them at the hospital with Karin to give to the people who took care of me during the surgery."
It was a "magic cane," a paper work that Karin made with gratitude to the people at the hospital.
"It's a strange story, but since I decided to meet the teacher, Karin has been appearing in my dreams lately, and I wonder if it means that you should give this to the teacher"
The "walking sticks" that should have been made in large were interrupted due to the earthquake, and there were only four in total.
Dr. Takama received one of them.
Dr. Takama said, "I will take good care of you," and gently put it in his bag.
I thanked her and left Karin's house.
"Training is like real life, real is like training"
The next day, Dr. Takama was in charge of treating emergency patients at the scene of emergency as usual.
In between, he told us the following.
"Personally, I don't think doctors are a big deal, but when patients get better, they say, 'Thank you, doctor,' and leave. I think that's the motivation for this job, but yesterday, when I saw her altar and her school bag, it came back to me that I was genuinely frustrated."
"I don't know if going back to that time will work, but if I'm frustrated, I'll use it as a springboard to work a little harder. So, if I can't do it one more time, I'll go back again, and what I couldn't do at that time, I'll definitely do well next time. If you face disaster medicine and ask me what the future holds be, I think that's the feeling that I will do it next."
Network News Department Reporter
Souya
SugimotoAfter joining the Kumamoto Bureau in 2015, he experienced
the Kumamoto earthquake in his second year in the Network News Department
, and has been covering the bereaved families and disaster-related deaths of the earthquake.
Chiba Broadcasting Station Reporter
Shinichiro
Sakurai joined the Nagasaki station in 2015After working at the Nagasaki station, the Narita branch of
the Chiba station Kumamoto earthquake was covered from Nagasaki
and experienced the main shock at Mashiki Town Hall.
Good morning Japan Director
Soichiro
Nagao joined the Hiroshima Bureau
in 2016 and then went to Good Morning Japan in Tokyo, where he experienced disaster reporting due to
heavy rain Japan west, covering medical care and disasters.