たった一日の実習で、人生の最期に出会った。
――医学部2年生が学んだ、もう一つの医療
先日に続いて、今日も杏林大学医学部の2年生が、かしま病院に一日だけの臨床実習にやって来ました。
今回も、東京からはるばる福島県いわき市まで。
大学近隣にも実習先はたくさんあるのに、どうしてまた、こんな遠くまで（笑）。
聞いてみると、数年前にかしま病院で1か月間の実習を経験した、部活動の先輩から勧められたのだそうです。
何とも嬉しい話です。
かつて実習に来てくれた学生さんが、知らないところで後輩にかしま病院を紹介してくれていた。
本日書いた「家庭医療ジャングル」の、また新しい芽吹きです。
さて、そんな学生さんに、今日は超高齢社会における「より良い死別」についてお話しする機会がありました。
人は誰でも、いつか人生の最期を迎えます。
医療の進歩によって多くの命が救われるようになりましたが、それでも避けられない死はあります。
そんなとき、医療には何ができるのでしょうか。
奇しくも、この日の実習では、進行性の疾患によって人生の最終段階にあった患者さんの看取りの場に立ち会うことになりました。
学生さんにとっては、人の死を初めて目の当たりにする経験でした。
当然、大きな衝撃があったと思います。
しかし、そこにあったのは、悲しみや緊張ばかりではありませんでした。
長年寄り添ってこられたご家族が、まるで「お疲れ様」と声をかけるように、大切な方の最期を温かく見守っておられました。
その場には、静かで穏やかな空気が流れていました。
もちろん、死別に悲しみがないわけではありません。
穏やかに見送ることができたからといって、寂しさがなくなるわけでもありません。
それでも、人生の最期が、ただ恐ろしく、つらいだけの時間にならないように。
ご本人の尊厳を守り、ご家族がその別れを少しでも受け止められるように。
医療には、そうした時間を支える役割もあるのです。
病院は、命を救う場所です。
しかし同時に、避けられない死を少しでも穏やかなものにし、ご家族が大切な人との別れに向き合えるよう支える場所でもあります。
救命できなかったから、医療の役割が終わるわけではありません。
むしろ、治すことが難しくなったときにも、医療にできることはたくさんあります。
苦痛を和らげること。
ご本人の意思や価値観を尊重すること。
ご家族の不安や悲しみに寄り添うこと。
そして、その人らしい人生の締めくくりを支えること。
それもまた、医療の大切な仕事なのです。
医学部2年生にとって、今回の経験は、まだ十分に整理できないものかもしれません。
それでいいと思います。
人の死を目の当たりにして、簡単に答えが出るはずもありません。
むしろ、心に残った戸惑いや驚きを、これからの学びの中で少しずつ考え続けてほしいと思います。
人の命を救うために医学を学ぶ。
そして、人の人生を最後まで支えるためにも医学を学ぶ。
この二つは、決して矛盾するものではありません。
たった一日の実習でした。
けれども、学生さんは、医師という仕事の大切な一面に触れることになりました。
いつか医師になったとき、今日の経験を思い出すことがあるかもしれません。
そのとき、患者さんの死という出来事だけでなく、ご家族が大切な人を温かく見送っていた、あの穏やかな空気も思い出してくれたら嬉しいです。
そして、もう一つ。
数年前にかしま病院で学んだ先輩が、後輩にここでの実習を勧めてくれたこと。
その小さなご縁が、今回の大切な学びにつながりました。
やっぱり、種は蒔き続けてみるものですね。
どこで芽が出て、どんな出会いにつながるのか。
これだから、地域医療教育はやめられません。
A One-Day Clinical Experience, a Lesson About the End of Life
— What a Second-Year Medical Student Learned About Another Essential Role of Medicine
Once again, a second-year medical student from Kyorin University School of Medicine visited Kashima Hospital for a one-day clinical placement.
And once again, the student had traveled all the way from Tokyo to Iwaki, Fukushima.
There were plenty of hospitals and clinics much closer to his university. So why come all this way?
As it turned out, a senior member of his university club had spent a month training at Kashima Hospital several years earlier and had recommended the experience.
What a wonderful surprise!
Someone who had trained with us years ago was now encouraging the next generation of students to visit.
Another unexpected seed had sprouted in what I called our Family Medicine Jungle, today.
But this particular day had something extraordinary in store.
Learning About a Good Farewell
During the placement, I had an opportunity to talk with the student about what it means to support a good farewell at the end of life in a super-aged society.
Everyone's life eventually comes to an end.
Modern medicine has made remarkable progress, allowing us to save lives that might once have been lost.
Yet there are still deaths that medicine cannot prevent.
When that time comes, what can healthcare professionals do?
By coincidence, during that very day's placement, the student had an opportunity to be present as a patient with a progressive illness, who was approaching the end of life, passed away.
It was the first time he had witnessed someone's death.
Understandably, it was a profound and emotional experience.
But what he encountered was not simply a scene of grief or distress.
The patient's family, who had shared so many years together, gently accompanied their loved one through those final moments.
There was a warmth in the room, almost as though they were quietly saying,
“You've worked so hard. Thank you. You can rest now.”
The atmosphere was peaceful and deeply human.
Of course, a peaceful farewell does not mean there is no sadness.
Nor does it make the pain of losing someone disappear.
But it showed another side of medicine—one that is just as important as saving lives.
A Hospital Is Not Only a Place Where Lives Are Saved
Hospitals are places where we work to save lives.
But they are also places where we help people approach an unavoidable death with dignity, and support families as they say goodbye to someone they love.
When a cure is no longer possible, our responsibility does not simply end.
There is still so much that medicine can offer.
Relieving suffering.
Respecting the patient's wishes, values, and dignity.
Listening to the concerns and emotions of family members.
Helping people spend their remaining time in a way that reflects who they are.
And supporting families as they face one of life's most difficult transitions.
These are not secondary tasks.
They are essential parts of healthcare.
In family medicine, we care not only for diseases but also for people—their lives, relationships, families, and communities.
That commitment does not disappear when life is drawing to a close.
In many ways, it becomes even more important.
Some Lessons Take Time to Understand
For a second-year medical student, witnessing death for the first time can be overwhelming.
I do not expect him to have fully understood everything he experienced that day.
Nor should he have to.
There are experiences in medicine that cannot be neatly explained or understood in a single afternoon.
Sometimes, the most meaningful learning begins with uncertainty.
With surprise.
With questions that stay with us long after the day is over.
I hope he will carry those questions with him as he continues his medical education.
Because becoming a physician is not simply about acquiring the knowledge and skills needed to diagnose disease and save lives.
It is also about learning how to accompany people through suffering, uncertainty, and the final stages of life.
We study medicine to save lives.
And we study medicine to care for people until the very end.
These two responsibilities are not contradictory.
They are inseparable parts of being a physician.
The Seeds We Plant
It was only a one-day clinical placement.
Yet in that short time, the student encountered an essential dimension of medical practice.
Perhaps years from now, when he is working as a physician, he will remember this experience.
And when he does, I hope he remembers not only the fact that a patient died, but also the gentle, peaceful atmosphere in which the family accompanied their loved one.
The warmth.
The dignity.
The quiet sense of gratitude for a life shared.
And there is one more thing that makes this story special to me.
Several years ago, another student spent a month learning at Kashima Hospital.
That student later recommended our hospital to a younger colleague.
And that simple connection led to today's remarkable experience.
Once again, I am reminded that planting seeds is worthwhile, even when we have no idea where they might eventually take root.
We never know where a seed will sprout—or what meaningful encounter it might lead to.
And that is precisely why I never grow tired of teaching family medicine in the community.
