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Kaleidoscope of the Heart: How far should the role of a doctor extend?

Rika Kayama

Through social media networks like Twitter, you occasionally end up learning about the everyday life of someone whose name and face you do not know but it feels as if you know more about them than a close friend.

    Recently, on a woman's Twitter, I learned that her husband had been diagnosed with a serious disease, and with its progression, he was admitted into the care of a hospice, where he died. Along with tweeting about her husband's condition, the woman also wrote about her own feelings throughout the experience and how she felt about the medical treatment process among other things. As an individual involved in the medical field, her tweets got me thinking.

    According to the woman, the doctor in charge of her husband at the hospice would come into his room around 7 a.m. each morning once his condition started to decline, hold his hand and look into his face, and when the woman would come to stay with her husband overnight, the physician would come and talk with her about various things -- illness, problems with Japan's medical treatment system, an interesting episode from the doctor's own childhood, stories of their hometown... It was during those talks that the doctor apparently said to the woman, "In medical school, I was taught that medical treatment cured illnesses. But there are so many illnesses that doctors cannot cure. So I am thinking of what it is I can do in this situation."

    The woman was someone with a strong interest in societal issues, and one morning, she had gone from being "a wife taking care of her husband" to "a woman thinking about current medicine," and must have been happy when she could discuss her opinions with the doctor. She must have also been grateful for that primary physician, who stayed by her husband's side from the morning, devoting long hours to his care.

    This summer, after the scandal concerning the doctored medical school entrance exam scores of female applicants to keep them out of medicine, the issue of what kind of work style would allow women to continue in the profession even after giving birth and while raising their children was discussed here and there. I even happened across the introduction of a hospital that "realized an eight-hour workday for doctors by abolishing the primary physician system and changing to a shift system" as a possible model.

    Of course, as a doctor, you would be able to both rest your body and balance your family life if there was a system where you concentrated on treating your patients while at the hospital, and once that was done, even if the condition of the patient in your care changed, you would not be called back to work. Even I thought, "There is no other way than a shift system, is there?"

    However, I learned from the woman on Twitter just how much comfort and support a patient and their family can get from a primary doctor who clocks into the hospital early in the morning and takes the time to connect with patients who are facing the prospect of dying.

    Then I thought, "Since they deal with something as important as human life and death, isn't there a need for doctors to sometimes exert themselves in order to act as a source of strength for their patients?" But then my thoughts returned to, "No, if that is the case, then especially female doctors will be unable to maintain work-life balance," and I was once again left without an answer. What should physicians do? It remains an important and difficult issue. (By Rika Kayama, psychiatrist)

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