Radio Nippon presents, �gSugahara Akiko�fs Ichigo Ichiwa�h
Guest is Kamata Minoru

S: How are you, listeners? Today�fs guest is Dr. Kamata Minoru who is a doctor and has produced amazing fruits in the terminal care and the regional medicine for many years. The regional medicine is now coming to a head of collapse with the problem of medical expenses and of the lack of doctors in Japan. The situation is so hard. I guess that we can hear about various topics which are how the regional medicine will succeed and the way of hospices toward the cancer in this situation. I wonder what story we can hear. Please look forward to it.

You were born in 1948 and in the baby-boom generation. And I have ever read in your book �gI won�ft work hard�h that you took part in some student movements while you were in the Tokyo Medical and Dental University. But did you work so hard in the movements?

K: Just a little.

S: And you started to work in the Suwa Central Hospital in Nagano Prefecture. It wasn�ft related to the movements, was it?

K: Yes, it was.

S: Really?

K: I had said some antiestablishment things. And it was prominent at that time that the medical care in the university was for researches and the way to be an important person. I had criticized such medical treatments and after the movements, I didn�ft think it cool as the way of life that I would go back to the university to pass the way earnestly to be great. At that time, we would often say a word, �gself-denial�h. As I stood under the slogan of �gself-denial�h, the word was going alone at the same time. It was strange. When I said that I would go to a country, every my classmate and my senior said, �gDon�ft leave the capital�h.

S: Then your book also says that you went there to find people similar to you and that many comrades have got together from here and there.

K: Yes, that�fs right. That time was an interesting age and people who had S: willingness assembled. And it was also good that we were from different universities or colleges. Not from the same university but from different universities discussed seriously for inhabitants what good medical care would be.

S: I heard that you had reflected about a good medical care, not given medicines, heard from people so much and had talked to them about preventions but that elderly people would have not appreciated you.

K: In countries, they had a belief in the injection which they assumed that injections would make them fine. And they asked for an injection against a little fatigue. After all, doctors before us obeyed their demands to give it to them. Reversely we wanted to decrease unnecessary medicines however few they would be and to convert injections into medicines for internal use. And we explained that to elderly people so that they bashed us so much. However after they began to understand that we had really worried about them, more and more patients came to us. It was an area where so many people had had a stroke, so we went to the region after work about 80 times a year and started a movement to decrease the number of strokes. Then that region was the area of many stroke patients, the medical expenses was so high and it cost so much for National Health Insurance. But we started the movement for health and its effect began to appear for 3 years. Now that region was one of the longest life regions. Longevity means many aged people and that it would cost so much for medical expenses. But the medical expenses for the aged in Nagano Prefecture of that city have cost the lowest-priced in those of the 19 cities in Nagano Prefecture for 5 years.

S: Is it Suwa?

K: No. It is next to Suwa, Chino City

S: Now they are being worried about that Japan can�ft last unless they cut down the medical expenses. And they actually are doing it. But I think that you have a key of longevity and health regardless of the actual low-priced medical expenses. I guess that except hospitals, staffs like public health nurses or nurses have relationships of mutual trust so that it functions well.

K: Yes, it is. Now they has an organization of public hearth nurses and health volunteers called �gHealth Guidance�h.

S: It is a little rare, isn�ft it?

K: Yes. Now 300 people take charge of that in the city of 57,000 people.

S: Then, do some citizens stand for a staff to be coached by public nurses?

K: Yes, they do. And they study about health well for a year. It will be useful to both their health and that of their family and assist nurses to take care of people of their neighborhood.

S: They work around.

K: And they hold a study meeting a month in the area. And we�fre invited there to study face to face. After meetings, having some tea and listen to the voice of inhabitants, �gI want hospitals to be like this�h. As a result hospitals will change little by little.

S: It won�ft cost so much and volunteers take care of residents and at the same time, they study for themselves. It is an ideal way.

K: 300 people work as a staff and nearly 7,000 people have experienced it.

S: It is amazing. 7,000 people of 57,000 people?

K: That�fs right.

S: It is a large number of people.

K: I guess that it is the biggest key of the lowest-priced medical expenses, health and longevity. It is the fact that well-informed people of medical association, doctors of the region and public nurses played their role largely, but I think that the power of inhabitants produced effect the most.

S: It will be one of the solutions for the future of Japan, isn�ft it?

K: Yes, it is. I published a book of health, �gIt Is All Right To Be A Little Fat�h about how I made the region healthy in Chino city. I had promoted 6 ways: to cut down salt intake, to ingest a fiber, to eat colored vegetables, to have fish, to exercise and to warm their mind. Then it affect greatly.

S: It is easy to understand. I visited Nagano Prefecture to investigate into epidemiology when I was a graduate student. Then they gave me a china bowl of pickles of nozawana for refreshments of tea and said, �gIt is a snack�h. And after research, I found that fish which they had eaten was fish preserved in miso. That was too salty. I thought, �gIt isn�ft fish�h. But they had eaten it thinking that it was fish. At that time average intake of salt was 40g in Nagano Prefecture.

K: When I moved there, it was 25g. At the time I went, it was less than your time. But 25g is a large mount of salt. I can�ft believe that.

S: The 40g has been continued there. So I had never thought that it would be improved.

K: I was shocked, too. I went to lecture meetings 80 times a year and gave a lecture to reduce the number of stroke. I repeated the words, �greduce the intake of salt�h many times while the meeting. But after the meeting, middle-aged ladies said, �gThank you for coming to the top of the mountain. Have some tea�h but they gave me tea with so much nozawanas pouring pieces of dried bonito and soy sauce and said �gHere you are�h. They understood nothing. It is difficult for human beings to change themselves. But, it is a technical term, unless they make behavior modification, it will make no sense no matter how they practice a health movement. Nor unless we touch inhabitants�f mind, the lifestyle won�ft change even though I tell good story. I noticed it. And I could learn how we change their lifestyle.

K: Though it is difficult for human beings to change, I believed that it would be sure for them to be able to change themselves. It takes long time. But
It is good point of the regional medicine that I don�ft examine just once but we keep contact with each other to change in a long time. And we did it. It is a hospital of happiness.

S: For example, the home care takes manpower the most, doesn�ft it? Considering that a hospital sends a doctor and a nurse and that they make the rotation, the loads on the hospital are much pretty, aren�ft they?

K: Yes, much pretty.

S: Unless they have hands enough, they can�ft do properly. Even if they try to warm patients, firstly the hands will precede anything. How do you solve such problems?

K: Though it is a countryside hospital, we have prepared to react in case where a new system would be established like the current 7-to-1 nursing which needs nurses the most. I don�ft mean full of nurses. Compared to other regional hospitals, we don�ft say about the management and we do something necessary warmly. Then, I wrote my new book, �gIt Can Be Vague�h, for example, when a cancer patient who was an owner of a restaurant wants to make a dish before he dies, he makes in the kitchen of hospice to let us have it. We can do nothing to him medically, but we remove his pain as much as possible, not only physical pain but also mental pain to release him from regrets. If he/she likes cooking, we let him/her make a dish once more. When he/she is in a hard situation like that, we use our imagination for him/her and devote ourselves to ease him/her no matter how little the pain is. We keeping such things, nurses get so happy to take root more. They are originally tender people so that they want to do something tender. Therefore if we go back to the basics which the medical treatment is warm, I guess more and more doctors and nurses will want to engage in it and will be fixed there.

S: Hearing your talk, when my father got cancer, it was not so. He wanted to do this and that. I pushed him in a wheelchair to beach and let him see the sight of morning, the next day we were told not to do that. We were said, �gIt is prohibited�h. And though I had asked staffs to give him morphine to the pain in the last time and they had accepted it easily, they did not do that. I asked, �gWhy?�h, and they answered, �gIf he dies now, it may be regarded as a fault of the hospital and be accused�h. They didn�ft give it to him. I claimed, �gYou said you would give him�h, but they didn�ft when it comes to the time. I have undergone such things. I feel so large difference in cancer.

S: Now a cancer patient is in our hospital and she came to us by car and train spending about 7 hours from the south. At first she looked so painful but he has gradually got cheerful. Her husband attends her. When her doctor recommended, �gThe sight of this point is so good�h, they drove there together. Other time when a nurse said, �gNoodle in this restaurant tastes good�h, they went to eat it together�h. And someone said, �gWasabi fields of Asumino look beautiful�h, they went there to see them. The two have gradually become fine. The husband had been broken because of weakened wife but they now, the two, smile so happily. Of course there works her doctor�fs technique, removing her pain even using morphine. The bond of family has been getting strong. And nurses around the two have got happy, too. By getting smile from the patient. We are also encouraged. So it created a good multiplier effect.

S: You are involved in volunteer works energetically and you acted a relief operation for Chernobyl. Did you take part in it by request or by yourself?

K: I wrote about my background in four books of the series of life, �gI won�ft work hard�h, �gI won�ft give it up�h, �gStill I won�ft work so hard�h and �gI won�ft dump it on�h. When I was a year old, my parents couldn�ft raise me anymore so that they deserted me. But a poor couple, husband was a taxi driver and thy took care of the sick, received me and raised me since that. And I feel strongly, �gI was raised by someone�h. Now I think that I must return what I was done. This is one of the reasons why I went to the hospital of Chino city in Nagano Prefecture where they lacked doctors. 17 years ago, I heard that children were dying without proper medical treatment in the area of radioactive contamination in Chernobyl. And I wanted to do however little what I could. Finally I sent groups of doctors 90 times and medicines worth 1.4 billion yen so that children had gradually recovered.

S: Did you collect 1.4 billion by any campaigns to raise funds?

K: Yes, we did. Now we have sent 4 million�fs worth medicines to 4 children�fs hospitals every month since 4 years ago. It is also by donation with words, �gIt�fs just a little money�h. And we can buy medicines for children and leukemia children have been recovered. Our two countries have known each other and have been getting reliable each other. Iraq will someday be regenerated and Japan will import petroleum from Iraq. I think it important to build the safety net of Japan that we now are making good friendly relationships.

S: That�fs right.

S: There are various things on the table. What are they?

K: I want to save the children of leukemia or cancer. This girl had osteosarcoma to be amputated her whole right leg. And she drew a picture of a girl with only one leg as a portrait.

S: It�fs so pretty a picture.

K: And wrapped with it, safe and tasty chocolates from Hokkaido are sold every year as Valentine chocolates. One chocolate is sold for 500 yen and we sold 34,000 last year.

S: Amazing.

K: This year we aim to sell 70,000. So I wish our televiewer would buy them.

S: Yes. We wish many people would buy them.

K: And these are jazz CDs with cooperation by a very famous sax player, Mr. Sakata Akira. We made CDs titled, �gSunflower�h and �gRice Ball�h. Most of Sales will be used for medicines. Not just collecting contribution but those who buy these products will enjoy high-quality music and chocolates to cooperate to save children�fs life.

K: I wish you will buy these products.

S: Yes. I hope many people buy them.

S: Your new book�fs title, �gIt Can Be Vague�h, has a warm and amusing cover. What does this title mean?

K: When I was 48 years old, I got nearly into panic disorder. I got insomnia and had cold drops come out on my skin. At that time, I walked on thin ice because being a director of hospital, I had tried to enrich high-quality medical care and a emergency medicine and to make management make into the black. Then I noticed that I was beyond my ability. In the society of Japan, though we have the words like �gIIKAGEN (vague)�h, �gHODOHODO (moderate)�h and �gSAITEKI (the most suitable)�h, we will not be appreciated unless we work so hard to exceed �gthe most suitable.

S: I see. Then the word, �gvague�h means �ggood adjustment�h, doesn�ft it?

K: Yes, it is. I try to express �gII (good)�h �gKAGEN (adjustment) �g, as the words but during writing, exceeding the meanings of these words, I gradually noticed that the word, �gIIKAGEN (vague)�h would be more suitable than the words above because I had thought that we would live to have an end at last.
For example, I will talk about the first part of this book. I met a latter-half-of-his-70�fs in a ski area in Switzerland. I thought it rare that a person of such age traveled by himself and called out to him. Then he said, �gI had a big operation on cancer of the liver and this may be my last skiing�h. I asked if he was so rich. He answered, �gI was an ordinary office worker and now I live on my pension. I have saved my pension to come here. So I have never had a meal in the restaurant or from hotel services but I have bought foodstuffs in a supermarket to make a dish by myself in my room. This may be my last skiing in my life, so today I will eat the dinner�h. I thought he wasn�ft beaten by both disease and aging. And I also felt, �git is enough to live as what he is till the end of time�h. And I thought that perhaps his disease would got well and that would be able to overcome the cancer. �gNo. I�fm sure that you will be better. The operation for cancer of the liver has being progressing. I know that it will be hard. But your immunocompetence will get strong and you will be better. So why won�ft you come skiing next year again?�h I asked and he smiled so happily. Then I felt �git is enough for human beings to live vaguely�h. Including that I had run into a stone wall and that I had nearly got into panic disorder, I wrote this book of 40 stories like that to say, �gIt is enough for human beings to live not so hard�h. Since 4 years ago I have carried out a project, �gLet�fs go to Hawaii with Kamata Minoru�h with about 150 disabled people. A person on a wheelchair who had had a stroke came with me for years ago thinking it as her last trip and said, �gIt was so nice�h. At that time I got a witness of a golden wedding for a couple of terminal cancer. Looking that, he decided to live to the time of a golden wedding in Hawaii. And he gradually recovered with hope to need no wheelchairs.

S: Did he come to be able to walk?

K: Yes, he did. He walked with a shuffle with his wife on the aisle of the church in Hawaii. And they took pictures. They walked with tears so that we also cried in sympathy. After all human beings have to live warmly since now. From now on, I think a few of hard years will last after the economy collapses. It is important for us to make our heart warm for our own health, to make the warm education for the renewal of education and to carry out warm projects for our country. I think that we had better aim for being warm in 2009.

S: Yes. Thank you for talking with me.

S: I think that it is now so hard for doctors to talk about hope, romance or something like that. Now situations of doctors who work in the hospital are so hard because their working time last for 32 hours, 36 hours and more. In such situations, like Dr. Kamata, many cooperators stand together around doctors to make a new type of medicine, and nurses and volunteers of the region work close. This type of models in which they succeed new ideals and romances practically is much valuable, I think. I wish that the hospitals of our area hold such ideals and in its dream or romance, not saying �gimpossible�h, following successful models or seeking them to become wonderful ones where ordinary people like us can go with so much gratitude. In this meaning, too, his story makes us have a big hope.

Translation by Yuka Yamashita