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Campus Now

Spring Verdure Issue (May. 2013)

Message to the second century

Utilizing the strengths of university to approach healthcare for the elderly through a diverse partnership

Utilizing the strengths of university to approach healthcare for the elderly through a diverse partnership

Dr. Mikihito Ishiki
Iwate Prefectural Takata Hospital
Chairman, Iwate Prefectural Health Service Bureau

As the Director of Takata Hospital, the only general hospital in Rikuzentakata City, Iwate Prefecture, Dr. Mikihito Ishiki has worked hard to reconstruct regional medical care-even while losing members of his own family in the Great East Japan Earthquake. Dr. Ishiki discussed his memories of student life at Waseda University, as well as his expectations for Waseda in the future.

Developing the ability to think while studying at university

――What kind of student life did you spend at Waseda University?

My family runs its own clinic and my parents wanted me to study medicine. However, I wasn't interested in medicine when I was in high school and I entered the School of Science and Engineering at Waseda University in order to study electrical engineering, which was a popular field at that time. Student demonstrations were very common then. Still, I enjoyed a fulfilling student life, going to cheer for Waseda's baseball team at the championship of the Tokyo Big 6 Baseball League and interacting with friends from the Student Tomon Association of Aomori, the prefecture where I was born. I was also stimulated by university classes which were unlike anything that I had experienced in high school. One of my professors wrote a problem on the board, told students to write a report summarizing the answer and then left the classroom. Finding the answer took about 2 or 3 hours even for my smartest classmates. However, I wasn't satisfied by simply copying the answers of my classmates, so I consulted my mathematics textbook and struggled with the problem by myself. I continued thinking even when at home and I sometimes dreamt that I had figured out the answer. Afterwards, when I began studying medicine, I mainly had to remember facts which had already been substantiated. There was no time for me to concentrate and think. In that respect, developing the "ability to think" while studying at Waseda University was of great meaning to my future life.

――Why did you decide to change from the School of Science and Engineering to studying medicine?

I decided to change my path when I entered a "medical electronics" laboratory which applied electrical engineering to medicine. At the time, I had been conducting joint research with doctors. For example, I was asked to process medical body data by doctors and I visited hospital to gather electrocardiogram data for my graduate research theme of "automatic measurement of electrocardiograms." While working together with doctors, I felt the strong desire to study medicine.

Even within current conditions, there is always a course of action

――As a doctor and as Director of Takata Hospital, Iwate Prefecture's core hospital, you have worked tirelessly to reconstruct regional medicine. What have you valued the most within your work?

I believe that it is vital to manage the hospital based on an understanding of its role in the community. I also place importance on finding a course of action even within the current conditions.

The lack of doctors at small community hospitals had begun to become a serious problem from about 10 years before I became Director of Takata Hospital in 2004. The main reason is that the specialties of doctors have become increasingly diversified and there has been an increase of doctors who can only see patients in their specialized field. For example, several specialists are required to operate a single department of internal medicine. This made it difficult to acquire enough doctors at small hospitals. Furthermore, around the time when I became Director, Iwate Prefecture enacted a policy which positioned Takata Hospital as a regional hospital supporting Oohunato Hospital, a core hospital which handles medicine in Iwate Prefecture. However, this policy wasn't fully understood by citizens in the community and the number of patients at our hospital decreased. In response, we implemented the theme of a "hospital which kindly serves elderly patients." Specifically, we improved medicine for the elderly, formed partnerships with nursing care practitioners, enhanced visiting examination, provided a high level of hospitality at outpatient reception and held study sessions for hospital staff. Through such measures, the awareness of doctors began to change gradually and our hospital has now been reborn with renewed vitality. Although our hospital was operating in a deficit of several hundred million yen every year, we turned a single-year profit in fiscal 2011. Just when we were thinking of taking new action in fiscal 2012, the Great East Japan Earthquake occurred.

Support from friends was a great encouragement

――Takata Hospital was severely damaged by the Great East Japan Earthquake. Would you please discuss conditions at and after the time of the earthquake?

I had never experienced such powerful tremors before. After they subsided, we were struck by a tsunami which reached the 4th and highest floor of our hospital. A total of about 160 patients, staff and local citizens spent a cold night on the hospital roof before being rescued by helicopter the next day. I will never forget the tragic sight of the town which I saw from the helicopter. Fortunately, all of our hospital staff was evacuated to the same emergency shelter. Once our presence was known, people gathered for examinations and we began practicing medical care again without a second's rest. There was absolutely no medical equipment and regional medical care had suffered catastrophic damage. I devoted myself to rebuilding the medical structure and could think of nothing else.

With Waseda students serving as volunteers (February 2012)

Then it happened. A friend that I had made while studying at Waseda brought a sleeping bag and came to volunteer in areas which were still strewn with rubble. I was surprised by his sudden arrival and I discussed many of our troubles with him. He then called out to former classmates for support and made every possible effort to help us. Unfortunately, our plan didn't come to fruition, but their support was very reassuring. Also, thanks to my friend's activities, we received offers of support from the Waseda University Hirayama Ikuo Volunteer Center (WAVOC). This support has continued in different forms such as activities by cultural clubs such as the Waseda University Mixed Chorus and Mandolin Club, sports support by athletic teams, and current educational support for children. I felt the true strength of Waseda.

――What kind of action is needed for regional medical care following the earthquake?

he foremost theme for regional medical care is how to approach the issues of a declining birthrate and aging population. Today, the ratio of senior citizens continues to increase, particularly in rural area. It is impossible to solve this problem through only medical and nursing care. Know-how from a variety of fields is required. For example, in the case of a patient who suffers from dementia and lives alone, know-how from science and engineering is used to attach a sensor to the patient in order to confirm their well-being via the internet. In order to solve the problem of medical care for the elderly, a national project is required with cooperation from various specialized fields such as sport sciences, psychology and education.

Finding a solution for the problem of an aging society through research projects only possible by Waseda

――Please discuss your expectations for Waseda.

When I was at the laboratory of Professor Akihiko Uchiyama at the School of Science and Engineering, a project was established for developing a humanoid robot at Waseda University. The project featured joint research for robot development, an area which had previously been conducted individually. The Uchiyama Laboratory was responsible for creating a brain to analyze and process information. Laboratories from multiple fields formed teams and cooperated to develop hands, feet, eyes, ears and a brain. From this project, I learned the importance of combining multifaceted knowledge and augmenting each other in order to solve a problem. I felt that such research across different fields arose naturally from Waseda's diversity.

I hope that Waseda University will utilize its strengths for the good of society in the future and will launch multidisciplinary projects for solving the various problems associated with an aging population.

Dr. Mikihito Ishiki
Iwate Prefectural Takata Hospital
Chairman, Iwate Prefectural Health Service Bureau

Born in Aomori Prefecture in 1947. Holds a PhD in medical science. Graduated from the Department of Telecommunications at the School of Science and Engineering, Waseda University. Left the Graduate School of Science and Engineering, Waseda University and entered the School of Medicine, Tohoku University. Worked at Iwate Prefectural Central Hospital from 1989. Became Director of Iwate Prefectural Takata Hospital in 2004. As the only general hospital in Rikuzentakata City, Dr. Ishiki worked to improve regional medical care such as enhanced visiting examination. He turned a profit at Takata Hospital, which had been operating in the red. He resigned from the position of Director in March 2013 and was appointed as Chairman of the Iwate Prefectural Health Service Bureau in April 2013. While continuing to conduct medical examinations at Takata Hospital, he works tirelessly to rebuild the regional medical infrastructure which was destroyed by the 2011 Great East Japan Earthquake.