医者を育てるのは、医者だけじゃない！ ――「いとち」が福島医学会で語ること It Takes a Community to Raise a Doctor! — The Itochi Project at the Fukushima Medical Society Symposium

 

医者を育てるのは、医者だけじゃない！

――「いとち」が福島医学会で語ること

11月29日、郡山市で開催される福島医学会学術研究集会。

今回のシンポジウムのテーマは、

「福島県の医者を、みんなで育てよう」

その第2部に、かしま病院総合診療科の渡邉聡子先生が登壇します！

演題は、

「ひとと街が、医療を育む――『いとちプロジェクト』が目指す、医療と地域の新しいつながり」

持ち時間は20分。

ところが、準備されたスライドは33枚。

……聡子先生、なかなかの欲張りです（笑）。

残念ながら、私も当日は聴講できません。

そこで、発表資料をひと足先に拝見し、内容を超簡単にご紹介します！

そもそも「いとち」って何？

「いとち」とは、「医」と「地」。

つまり、医療と地域です。

病院の中で医療者だけが頑張るのではなく、地域の皆さんと一緒に、健康や医療について考えようという取り組みです。

医師が街に出る。

医学生が住民と話す。

病院の駐車場でイベントを開く。

ときには畑仕事まで教わる。

「先生、今日は何の診療ですか？」

「今日は草むしりです！」

……そんな医療があってもいいじゃありませんか（笑）。

お医者さんの教科書は、街にもある

医学部では、病気の診断や治療を学びます。

でも、患者さんが普段どんな暮らしをしているのかは、教科書だけでは分かりません。

そこで「いとち」では、医学生や研修医が病院を飛び出します。

街を歩く。

住民の話を聞く。

人生の最期について語り合う。

保育園で子どもたちと遊ぶ。

地域の人たちと一緒に過ごす。

すると、不思議なことが起こります。

これまで「患者さん」としてしか見えていなかった人が、趣味も、仕事も、家族も、思い出もある、一人の人間として見えてくるのです。

病院では病気を学ぶ。街では人生を学ぶ。

これが「いとち」の医学教育です。

しかも、育つのは医者だけじゃない！

面白いのは、ここからです。

地域の皆さんも、医学生や医療者と交流するうちに変わっていきます。

以前は、

「病気になったら、お医者さんに全部お任せ！」

と思っていた方が、

「自分の健康について、お医者さんと一緒に考えよう」

と思うようになる。

医学生も、

「患者さんから医学的な情報を聞いたら、次は何を話せばいいんだろう？」

と悩んでいたのが、

「この人は、世界に一人しかいない、かけがえのない存在なんだ」

と気づくようになる。

医者が住民から学び、住民も医者から学ぶ。

どちらが先生で、どちらが生徒なのか。

もはや、よく分かりません（笑）。

でも、それがいいのです。

そして、気がつけばグッドデザイン賞！

そんな活動を、ああでもない、こうでもないと続けていたら……。

2025年度には第1回昭和上條医療奨励賞。

そして2026年度には、なんとグッドデザイン賞までいただいてしまいました！

医療機器を開発したわけでも、格好いい病院を建てたわけでもありません。

人と人がつながる仕組みそのものが、評価されたのです。

もっとも、最初から何もかもうまくいったわけではありません。

地域の交流拠点をつくっても、当初は来訪者がほとんどいなかったことも。

なかなか思いどおりにはいかないものです。

でも、そんな試行錯誤も含めて「いとち」なのだと思います。

医師を育てるのは、地域そのもの

今回のシンポジウムのテーマは、

「福島県の医者を、みんなで育てよう」。

私たちは長年、医師を育てるために、指導医を増やし、研修プログラムを整え、教育の仕組みをつくってきました。

もちろん、それは大切です。

でも、もう一つ大切なことがあります。

医師は、医師だけでは育たない。

患者さんが教えてくれること。

ご家族が教えてくれること。

地域の人たちが教えてくれること。

そして、街そのものが教えてくれること。

そうした学びの積み重ねが、人の暮らしを理解できる医師を育てていくのです。

そして、その医師たちが地域に出ていけば、今度は地域の皆さんも医療を身近に感じるようになる。

ひとが医療を育て、医療がひとを育てる。

これこそが、今回、渡邉先生が伝えようとしていることだと思います。

さて、聡子先生。

33枚のスライドを20分で語り切れるのか。

それとも、熱意があふれて時間が足りなくなるのか。

当日聴けない私としては、そこも少々気になるところです（笑）。

でも、一つだけ確かなことがあります。

福島県の医師を育てる教室は、大学にも、病院にも、そして街のあちこちにもある。

そのことを、渡邉先生がきっと伝えてくれるでしょう。

聡子先生、頑張ってください！

いわきから、全力で応援しています！

It Takes a Community to Raise a Doctor!

— The Itochi Project at the Fukushima Medical Society Symposium

On November 29, 2026, the Fukushima Medical Society will hold its Academic Research Meeting in Fukushima Prefecture.

The symposium has a wonderful theme:

“Let's Raise Fukushima's Doctors Together!”

And in the second session, Dr. Satoko Watanabe of Kashima Hospital's Department of General Medicine will take the stage!

Her presentation is titled:

“People and Communities Nurture Healthcare: The Itochi Project's Vision for New Connections Between Medicine and Community Life.”

She has 20 minutes to speak.

And she has prepared 33 slides.

Well, Satoko certainly isn't short of things to say! (Haha!)

Unfortunately, I won't be able to attend the symposium myself.

So I took an early look at her presentation and decided to share a quick, easy, and hopefully entertaining preview!

What on Earth Is “Itochi”?

The name Itochi combines two Japanese words:

“I” (医), meaning medicine, and “Chi” (地), meaning community or place.

The idea is simple.

Instead of expecting healthcare professionals to solve every health problem from inside a hospital, why not work together with the people who actually live in the community?

Doctors step outside the hospital.

Medical students talk with local residents.

Community events bring people together.

And sometimes, healthcare professionals even find themselves learning how to work in a vegetable garden.

“Doctor, what kind of medical practice are you doing today?”

“Today? Weeding!”

Who says healthcare always has to involve a stethoscope?

The Community Is a Medical Textbook, Too

Medical schools teach students how to diagnose and treat diseases.

But textbooks cannot fully explain how people actually live.

What matters to them?

What makes them happy?

What worries them?

What relationships shape their lives?

That is why the Itochi Project encourages medical students and residents to leave the hospital and explore the community.

They walk through neighborhoods.

Listen to local residents.

Talk about life, health, and death.

Spend time with children.

And discover the everyday lives of the people they may one day care for.

Something remarkable begins to happen.

People who might previously have appeared simply as “patients” become individuals with families, jobs, hobbies, memories, and dreams.

We learn about diseases in hospitals.

We learn about life in communities.

That is the heart of Itochi's approach to medical education.

Here's the Twist: Doctors Aren't the Only Ones Who Grow!

This is where things get even more interesting.

The people living in the community begin to change, too.

Someone who once thought,

“When I get sick, I'll just leave everything to the doctor!”

may begin to think,

“Perhaps I should take a more active role in my own health and work together with healthcare professionals.”

Meanwhile, medical students who initially struggle to talk with patients beyond asking medical questions begin to recognize something important.

Every patient is a unique human being, with a life that extends far beyond their medical condition.

Doctors learn from community members.

Community members learn from doctors.

And eventually, it becomes difficult to tell who is the teacher and who is the student.

Which is exactly how we like it!

And Somehow, We Won a GOOD DESIGN AWARD!

We kept experimenting, connecting people, and trying new things.

Not everything went smoothly.

Some of our early attempts to create spaces where people could gather attracted hardly any visitors.

Building meaningful relationships takes time.

But we kept going.

And then something rather unexpected happened.

In 2025, our efforts received the First Showa-Kamijo Medical Encouragement Award.

And in 2026, the Itochi Project received the GOOD DESIGN AWARD!

We hadn't invented a new medical device.

We hadn't constructed a spectacular hospital building.

What was recognized was something much less tangible.

The way we create opportunities for people to meet, connect, learn, and support one another.

Apparently, all those years of experimenting with community relationships had a name.

Social design.

Community design.

Who knew we were designers all along?

It Takes a Community to Raise a Doctor

The theme of this year's symposium is:

“Let's Raise Fukushima's Doctors Together!”

For many years, we have worked hard to improve medical education.

We have trained clinical supervisors.

Developed residency programs.

Created educational systems.

And welcomed students and young physicians into our hospitals.

All of these efforts are essential.

But through the Itochi Project, we have come to recognize something equally important.

Doctors cannot be raised by doctors alone.

Patients teach us.

Families teach us.

Local residents teach us.

And the community itself teaches us.

These experiences help young physicians understand not only diseases, but also the people who live with them.

And when physicians become more deeply involved in their communities, something wonderful happens in return.

Local residents begin to feel more connected to healthcare.

They become partners in thinking about health and well-being.

They help shape the future of healthcare in their own communities.

People nurture healthcare.

Healthcare nurtures people.

And together, they nurture the future of the community.

That, I believe, is the central message Dr. Watanabe hopes to share.

Twenty Minutes. Thirty-Three Slides. One Big Message.

Now, I do have one small concern.

Can Satoko really get through all 33 slides in just 20 minutes?

Or will her enthusiasm prove stronger than the conference schedule?

Sadly, I won't be there to find out!

But I am confident about one thing.

The places where we educate future doctors are not limited to universities and hospitals.

They are everywhere people live.

In neighborhoods.

In schools.

In community gathering spaces.

And in the countless everyday encounters that help us understand what it means to care for another human being.

That is what the Itochi Project is all about.

And that is the message Dr. Watanabe will bring to the Fukushima Medical Society Symposium.

Satoko, we're cheering you on from Iwaki!

Just one final request.

Please remember to breathe somewhere between slides 17 and 18!

Good luck!

たった一日で、医師になる原点に出会う。 Discovering the Meaning of Becoming a Doctor in Just One Day

 

たった一日で、医師になる原点に出会う。

――杏林大学医学部2年生、いわきでの地域医療体験

11月2日と6日、杏林大学医学部の2年生が、それぞれ一日ずつ、かしま病院に実習に来てくれました。

東京から福島県いわき市まで。

大学の近くにも実習先はたくさんあるはずなのに、わざわざ遠くのかしま病院を選んでくれたのです。

一人は、ご家族が高齢者の医療やケアに携わっていることがきっかけ。

もう一人は、数年前にかしま病院で1か月間実習した部活動の先輩から勧められたのだそうです。

特に後者は嬉しい話です。

かつて実習に来た学生さんが、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。

先日書いた「家庭医療ジャングル」の、また新しい芽吹きです。

さて、そんな二人から、大学に提出された実習報告が届きました。

これが、なかなか素晴らしいのです。

医師にとっては大勢の患者さんの一人。でも……

11月2日に実習した小松駿一郎さん。

外来診療や病棟での患者さんとの関わりを通じて、病気だけでなく、一人ひとりの生活背景を理解することの大切さを学んでくれました。

そして、報告書には、こんな趣旨のことが書かれていました。

医師にとっては大勢いる患者さんの一人でも、患者さんにとっては、自分の身体を診てくれる頼れる医師なのだ。

これは、実に大切な気づきです。

私たち医師は、毎日たくさんの患者さんを診ています。

忙しい外来では、ついつい「次の患者さん」「その次の患者さん」と考えてしまうこともあります。

でも、患者さんにとって、診察室で向き合う医師は、その瞬間、自分の健康や人生を託す相手です。

こちらにとっては日常の診療でも、患者さんにとっては大切な一回の診察かもしれません。

そんな当たり前で、しかし忘れてはいけないことを、医学部2年生が一日の実習で感じ取ってくれました。

そして小松さんは、今回の経験を通じて、医師になろうと決めた原点を改めて思い出し、これからの勉強をさらに頑張ろうと思ったそうです。

嬉しいですね。

医学の知識を教える前に、医学を学ぶ意味を伝える。

地域医療実習には、そんな役割もあるのだと思います。

医療は、一人ではできない

11月6日に実習した曹瑞洋さん。

この日は、病棟サポートチームの回診などを通じて、多職種が連携して患者さんを支える姿を見てもらいました。

報告書で特に印象的だったのは、医療者がそれぞれの専門性を発揮するだけでなく、患者さんの退院後の生活まで見据えて情報を共有していることに注目してくれた点です。

病気を治療する。

もちろん、それは医療の大切な仕事です。

でも、治療が終わったあと、その人はどこで、誰と、どんな暮らしを送るのでしょうか。

病気だけを診ていては、その答えは見えてきません。

医師、看護師、リハビリテーション専門職をはじめ、さまざまな職種が、それぞれの視点から患者さんを理解する。

そして、医療をその人の暮らしにつなげていく。

一人の患者さんを支えるために、たくさんの専門職が知恵を持ち寄る。

それが、地域医療の大切な姿です。

曹さんは、そんなチーム医療の意味を、実際の現場から学んでくれたようです。

もう一つの、忘れられない経験

実は、この日の実習では、もう一つ大きな経験がありました。

私は曹さんに、超高齢社会における「より良い死別」についてお話ししていました。

医療は、命を救うためにあります。

しかし、どれほど医学が進歩しても、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。

奇しくも曹さんは、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。

初めて目の当たりにする、人の死。

大きな衝撃だったと思います。

しかし、そこには、ご家族が大切な人を「お疲れ様」と送り出すような、温かな空気もありました。

私は学生さんに、こんなことを伝えました。

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、ご家族がその別れを受け止められるよう支える場所でもあります。

治すことが難しくなっても、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。

ご本人の意思や尊厳を大切にすること。

ご家族の思いに寄り添うこと。

そして、その人の人生を最後まで支えること。

それもまた、医師の大切な仕事なのです。

もちろん、医学部2年生が、たった一日でこの経験を十分に理解できるとは思いません。

むしろ、すぐに答えを出す必要はありません。

これから長い時間をかけて、何度も思い返し、考え続けてくれたらと思います。

学生さんが見ていたのは、私たちの姿だった

今回、二人の報告書を読んで、もう一つ嬉しかったことがあります。

それは、医療の知識や技術だけでなく、医療者が人とどう向き合っているかを、しっかり見てくれていたことです。

患者さんへの声のかけ方。

相手の立場に立って考える姿勢。

職種を超えて協力する様子。

そして、学生さん自身への接し方。

曹さんは、職員が忙しい中でも丁寧に質問に答えてくれたことや、病院全体の温かく和やかな雰囲気が印象に残ったと書いてくれました。

これは、院長として本当に嬉しい評価です。

医学生の教育というと、どうしても指導医の力量に注目しがちです。

でも、実際には、学生さんは病院のあらゆるところから学んでいます。

看護師の患者さんへの声かけから。

リハビリスタッフの何気ない配慮から。

多職種が意見を交わす場面から。

そして、忙しい仕事の合間に学生さんを温かく迎える職員の姿から。

病院そのものが、学生さんにとっての教科書なのです。

しかも、この教科書には、模範解答がありません。

あるのは、一人ひとりの患者さんと、その人生に向き合う医療者たちの姿です。

たった一日。それでも、種は蒔ける

今回の実習は、それぞれ、たった一日でした。

医学的な知識や技術を身につけるには、あまりにも短い時間です。

でも、医師になるとはどういうことなのか。

患者さんに向き合うとは、どういうことなのか。

医療は、何のためにあるのか。

そんな問いに出会うには、一日でも十分なのかもしれません。

小松さんは、医師を目指した原点を思い出してくれました。

曹さんは、チーム医療や患者さんとの関わり方、そして人生の最期を支える医療の一面に触れました。

二人が見たものは違います。

でも、そこから学んだことには、共通するものがあります。

医療とは、病気だけでなく、人に向き合う仕事である。

そして、もう一つ。

今回の実習のご縁をつないでくれた、数年前の実習生のことも忘れられません。

あのとき蒔いた種が、知らないうちに次の学生さんをいわきへ連れてきてくれました。

そして今回、また二人の学生さんの心に、新しい種が蒔かれたのかもしれません。

芽が出るのは、来年かもしれません。

10年後かもしれません。

あるいは、思いもよらない場所かもしれません。

それでいいのです。

教育の成果は、実習が終わった日に完成するものではありません。

その人の人生の中で、ゆっくり育っていくものなのでしょう。

さて。

家庭医療ジャングルを目指して、今日もせっせと種を蒔いております。

もっとも、最近は、以前蒔いた種が勝手に次の種を運んでくれるようになりました。

これは助かります。

何しろ、蒔いている本人は、そろそろどこに何を蒔いたか覚えていませんので（笑）。

小松さん、曹さん、遠くいわきまで来てくれて、ありがとうございました。

またいつか、どこかでお会いしましょう。

そのとき、どんな医師になっているのか。

今から楽しみにしています。

Discovering the Meaning of Becoming a Doctor in Just One Day

— Two Second-Year Medical Students from Kyorin University Experience Community-Based Healthcare in Iwaki

On November 2 and 6, 2026, two second-year medical students from Kyorin University School of Medicine visited Kashima Hospital for separate one-day clinical placements.

They traveled all the way from Tokyo to Iwaki, Fukushima.

Surely, there must have been plenty of hospitals much closer to their university.

So why choose Kashima Hospital, so far away?

One student became interested in our hospital because a family member was involved in healthcare and services for older adults.

The other came because a senior member of his university club, who had spent a month training at Kashima Hospital several years earlier, had recommended us.

Now, that was particularly heartwarming!

A student who had trained with us years ago was encouraging the next generation to come and learn here.

Another unexpected seed had sprouted in what I recently called our Family Medicine Jungle.

A few days later, we received the students' written reflections from their university.

And what wonderful reflections they were!

One Patient Among Many — But One Doctor Who Matters

The first student, Shunichiro Komatsu, visited us on November 2.

Through observing outpatient consultations and interactions with hospitalized patients, he learned the importance of understanding not only patients' illnesses but also their individual circumstances and personal backgrounds.

One observation in his report particularly caught my attention.

For a physician, someone may be one patient among many. But for that patient, the physician is someone they depend on to care for their health.

What an important realization.

As physicians, we see many patients every day.

During a busy outpatient clinic, it is easy to find ourselves thinking about the next patient, and then the next.

But for each person sitting in front of us, that consultation may be an important moment in their life.

What feels like an ordinary part of our working day may be an experience of great significance to the patient.

This is something we should never forget.

And a second-year medical student recognized it after just one day.

Komatsu also wrote that the experience reminded him of his original motivation for entering medical school and inspired him to work even harder in his studies.

That made me particularly happy.

Before teaching medical knowledge, perhaps we should help students discover why that knowledge matters.

Community-based medical education has an important role to play in that process.

Healthcare Is Never a One-Person Job

Our second student, Rui Cao, visited on November 6.

During his placement, he accompanied our multidisciplinary ward support team and observed how healthcare professionals work together to care for patients.

What impressed me most about his report was his recognition that good healthcare involves much more than treating the immediate illness.

It also requires considering what happens after discharge.

Where will the patient live?

Who will support them?

What challenges might they face in everyday life?

Treating a disease is, of course, an essential part of medicine.

But if we focus only on the disease, we may overlook the person who has to live with its consequences.

Physicians, nurses, rehabilitation professionals, and other members of the healthcare team each bring different perspectives.

By sharing information and working together, they can develop a more complete understanding of the patient's needs.

Supporting one patient often requires the knowledge, skills, and compassion of many different professionals.

That is one of the essential principles of community-based healthcare.

And Cao was able to see it in action.

Another Experience He May Never Forget

There was another significant experience during Cao's placement.

I had been speaking with him about the importance of supporting patients and families through the end of life, particularly in Japan's super-aged society.

Medicine exists to save lives.

But no matter how far medical science advances, there will always be deaths that cannot be prevented.

When that time comes, what can medicine offer?

By coincidence, Cao had an opportunity to be present during the final moments of a patient with a progressive illness who was approaching the end of life.

It was his first experience of witnessing someone's death.

I imagine it was deeply moving and perhaps overwhelming.

Yet there was also a gentle warmth in the atmosphere.

The family accompanied their loved one with a sense of tenderness, almost as though they were quietly saying,

“You've worked so hard. Thank you. You can rest now.”

I explained something that I believe every future physician should understand.

A hospital is a place where we work to save lives.

But it is also a place where we help people approach an unavoidable death with dignity, and support families as they say goodbye to someone they love.

Even when a cure is no longer possible, medicine still has much to offer.

Relieving suffering.

Respecting the patient's wishes and dignity.

Supporting the family.

And caring for the person until the very end.

These, too, are essential responsibilities of a physician.

Of course, I would not expect a second-year medical student to fully understand such an experience in a single day.

Nor should he have to.

Some experiences take years to understand.

I simply hope that he will remember what he witnessed and continue reflecting on its meaning throughout his medical education and future career.

The Students Were Watching Us, Too

Reading both students' reports, I was delighted to discover something else.

They had learned not only from medical knowledge and clinical practice, but also from the way healthcare professionals interacted with other people.

How staff members spoke to patients.

How they considered each person's circumstances.

How professionals from different disciplines worked together.

And how they treated the students themselves.

Cao wrote that he was particularly impressed by the warm and welcoming atmosphere throughout the hospital.

Even when staff members were busy, they took time to answer his questions carefully and explain things in ways he could understand.

As hospital director, I found that especially rewarding.

When we think about medical education, we often focus on the skills of individual clinical supervisors.

But students learn from much more than their assigned teachers.

They learn from a nurse's gentle words to a patient.

From the thoughtful attention of a rehabilitation professional.

From conversations between members of the healthcare team.

And from the way hospital staff welcome and support someone who is still learning.

The hospital itself becomes a textbook for medical students.

And unlike an ordinary textbook, it does not come with a single set of correct answers.

Instead, it offers countless examples of healthcare professionals trying to understand and support people with different lives, needs, and values.

That may be one of the most powerful forms of medical education.

Just One Day — But Enough to Plant a Seed

Each student spent only one day at Kashima Hospital.

One day is far too short to acquire substantial medical knowledge or clinical skills.

But perhaps it is long enough to encounter some fundamental questions.

What does it really mean to become a physician?

What does it mean to care for a patient?

And what is medicine ultimately for?

Komatsu rediscovered the motivation that had inspired him to enter medical school.

Cao gained insights into multidisciplinary teamwork, patient-centered care, and the role of medicine at the end of life.

Their experiences were different.

Yet their reflections pointed toward the same essential truth.

Medicine is not simply about treating diseases. It is about caring for people.

And there is one more connection worth remembering.

Several years ago, a medical student spent a month training at Kashima Hospital.

That student later recommended our hospital to a younger colleague.

And that simple recommendation helped bring another student all the way to Iwaki.

Seeds planted years ago were beginning to grow in places we had never expected.

And perhaps, during these two one-day placements, a few more seeds were planted.

When will they sprout?

Next year?

Ten years from now?

Somewhere far away from Iwaki?

We have no way of knowing.

And that is perfectly fine.

The true outcomes of education are not completed on the day a placement ends.

They develop gradually, through the lives and experiences of the people we teach.

So here we are, continuing to scatter seeds in our growing Family Medicine Jungle.

Fortunately, some of the seeds we planted years ago have started finding their own way into the hands of the next generation.

That is rather convenient.

After all, the person who started planting them is gradually losing track of where he put them!

Shunichiro and Rui, thank you for traveling all the way to Iwaki.

I hope our paths will cross again someday.

And when they do, I look forward to discovering what kind of physicians you have become.

Until then, keep learning, keep questioning, and keep growing.

Our Family Medicine Jungle is waiting for you!

注目の若手総合診療医、大塚勇輝先生がいわきに！ ――新・家庭医塾「カルテ記載のコツ」開催！ Dr. Yuki Otsuka Is Coming to Iwaki! — A Special Family Medicine Seminar on the Art of Clinical Documentation

 

注目の若手総合診療医、大塚勇輝先生がいわきに！

――新・家庭医塾「カルテ記載のコツ」開催！

今回の「新・家庭医塾」は、ちょっと豪華です！

講師にお迎えするのは、岡山大学病院 総合内科・総合診療科 助教の大塚勇輝先生！

若手総合診療医として全国的にその名を知られる、注目の先生です。

そんな大塚先生に、今回お願いしたテーマは、

「研修医の病棟業務への向き合い方――カルテ記載のコツ」

です。

カルテに自信がない。

もっと早く、もっと上手に書きたい。

気がつけば、患者さんと向き合っている時間より、パソコンと向き合っている時間の方が長い……。

そんな全国の研修医の皆さん！

今回は、まさに必聴です！

カルテは、単なる診療の記録ではありません。

自分の臨床推論を整理し、患者さんへの理解を深め、医師として成長するための大切な道具でもあります。

そのカルテと、どう上手に付き合っていくのか。

全国で活躍する大塚先生から学べる、またとない機会です。

しかも、参加無料！ オンライン参加も大歓迎！

これはもう、参加しない手はありません。

【開催案内】

日時： 2026年11月26日（木）18:00～19:00
講師： 大塚勇輝先生（岡山大学病院 総合内科・総合診療科 助教）
会場： かしま病院 コミュニティーホール
形式： ハイブリッド開催（オンライン参加可）
参加費： 無料
対象： 研修医を中心に、すべての先生方
申込締切： 11月24日（火）

お申し込みは、案内画像のQRコードからどうぞ！

カルテ記載に悩む研修医の皆さんはもちろん、指導医の先生方にもおすすめです。

全国区の大塚先生を、いわきで独り占めするのはもったいない！

全国の皆さん、ぜひご参加ください！

ちなみに、私自身もカルテ記載については、まだまだ修行中です。

長老になっても、カルテは勝手に書き上がってくれませんので（笑）。

Dr. Yuki Otsuka Is Coming to Iwaki!

— A Special Family Medicine Seminar on the Art of Clinical Documentation

We have a very special guest for our next Family Medicine Seminar!

We are delighted to welcome Dr. Yuki Otsuka, Assistant Professor in the Department of General Internal Medicine and General Medicine at Okayama University Hospital.

Dr. Otsuka is a nationally recognized rising star in Japanese general and family medicine!

And this time, he will be sharing his insights on a topic that every young physician knows all too well:

“Approaching Inpatient Care as a Resident: Tips for Better Clinical Documentation.”

Do you sometimes struggle with writing medical records?

Wish you could write your notes faster, more clearly, and more effectively?

Ever feel as though you spend more time staring at your computer screen than actually seeing patients?

If so, this seminar is for you!

Clinical documentation is much more than paperwork.

It helps us organize our clinical reasoning, communicate with colleagues, understand our patients more deeply, and grow as physicians.

So how can we make our documentation both meaningful and efficient?

This is a wonderful opportunity to learn from one of Japan's most exciting young generalists!

And here's the best part:

Participation is FREE, and you can join ONLINE from anywhere!

Event Details

Date: Thursday, November 26, 2026
Time: 6:00–7:00 PM (Japan Standard Time)

Speaker: Dr. Yuki Otsuka
Assistant Professor, Department of General Internal Medicine and General Medicine, Okayama University Hospital

Venue: Kashima Hospital Community Hall, Iwaki, Fukushima, Japan

Format: Hybrid (in-person and online)

Fee: FREE

Who Can Attend: All physicians, especially residents and clinical educators

Registration Deadline: Tuesday, November 24, 2026

Registration: Please scan the QR code on the event flyer.

Don't Miss This Opportunity!

Whether you're a resident struggling with clinical notes or a supervising physician looking for better ways to teach documentation, this session promises to offer valuable insights.

It would be a shame to keep Dr. Otsuka all to ourselves here in Iwaki!

So we warmly invite physicians from across Japan—and beyond—to join us online!

And for the record, I must confess something.

Even after becoming a hospital director, I'm still working on improving my own clinical documentation.

Apparently, becoming a hospital director does not make medical records write themselves! 😂

We look forward to seeing you on November 26!

「いとち」、NHKホールに立つ。 ――グッドデザイン賞2026、その先に見えたもの “Itochi” Takes the Stage at NHK Hall

 

「いとち」、NHKホールに立つ。

――グッドデザイン賞2026、その先に見えたもの

2026年11月4日。

東京・渋谷のNHKホールに、「いとちプロジェクト」の仲間たちが集まりました。

目的は、グッドデザイン賞2026の授賞式。

そうです。

私たちの「いとちプロジェクト」が、グッドデザイン賞2026を受賞したのです。

しかも、評価されたのは、医療機器でもなければ、病院の建物でもありません。

私たちが地域の皆さんと一緒に育ててきた、医療と暮らしをつなぐ取り組みそのものです。

正直なところ、何だか不思議な気持ちです。

いわきの街で、ああでもない、こうでもないと試行錯誤してきた活動が、まさかNHKホールの晴れ舞台につながるとは。

人生、何が起こるか分からないものですね（笑）。

私たちは、デザインをしていたのだろうか？

そもそも「いとちプロジェクト」は、何か立派な賞をいただこうと思って始めた活動ではありません。

病院の中だけで医療を完結させるのではなく、もっと街に出ていこう。

医療者だけで考えるのではなく、地域の皆さんと一緒に考えよう。

病気を診るだけでなく、その人が暮らす場所や、そこで紡がれる人と人との関係にも目を向けよう。

そんな思いから、少しずつ活動を広げてきました。

医療者と地域の人たちが出会う。

学生と住民が語り合う。

異なる職種の人たちが、肩書きをいったん脇に置いて、一緒に何かを考える。

ときには、何をしているのか一言では説明できないようなこともあります。

「それって、病院の仕事なんですか？」

そんな疑問を持たれたこともあったかもしれません。

でも、私たちは思うのです。

人が健康に生きるということは、病院の中だけで完結するものではない。

だからこそ、医療を街に置き、暮らしの中に人と人とのつながりを育てていく。

それが「いとち」の目指してきた姿です。

そして今回、その取り組みが「ソーシャルデザイン」「コミュニティデザイン」として評価されました。

なるほど。

私たちは、知らないうちにデザインをしていたらしいのです（笑）。

賞を取るために、つながってきたわけではない

今回の受賞を通じて、改めて感じたことがあります。

私たちは、賞を取るために地域とつながってきたのではありません。

地域とつながり続けてきたら、いつの間にか、その営みが「デザイン」と呼ばれるようになったのです。

これが、今回の受賞に対する私の率直な思いです。

医療者が地域に出ていく。

地域の人たちが病院に関わってくれる。

学生が学び、若い医療者が育ち、その人たちがまた新しい場所で活動を始める。

誰かが一方的に何かを提供するのではなく、関わる人たちが互いに影響を与え合いながら、少しずつ新しい関係をつくっていく。

そんな日々の積み重ねに、今回、一つの名前がついたのだと思います。

もちろん、賞をいただけたことは嬉しい。

関わってきた仲間たちの努力が、社会的に評価されたことも誇らしい。

でも、それ以上に嬉しいのは、私たちが大切にしてきた方向性は、決して間違っていなかったのだと、背中を押してもらえたことです。

NHKホールで見えた、次の景色

授賞式に参加した仲間たちからは、会場の熱気や、さまざまな受賞作品に触れた感動が伝わってきました。

グッドデザイン賞には、製品や建築物だけでなく、人の暮らしや社会の仕組みをより良くするための、多様な取り組みが集まっています。

その中で、仲間たちが特に関心を寄せていたものの一つが、医療者を支えるための居場所づくりでした。

病院で働く人たちは、日々、誰かを支えています。

患者さんを支え、ご家族を支え、地域の暮らしを支える。

では、その医療者自身は、誰に支えられているのでしょうか。

医療者もまた、一人の生活者です。

仕事から少し離れて、ほっとできる場所。

職種や立場を超えて、自然につながれる場所。

ときには、患者さんや地域の人たちとも、医療者と患者という関係を超えて出会える場所。

そんな空間があったら、医療のあり方も少し変わるかもしれません。

これは、「いとち」がこれまで大切にしてきた考え方とも、深く通じるものがあります。

医療を街に開くことは、医療者自身の暮らしを街に取り戻すことでもある。

授賞式は、これまでの活動を振り返る場であると同時に、次に何をしたいのかを考える機会にもなったようです。

「いとち」は、まだ完成していない

グッドデザイン賞を受賞したからといって、「いとちプロジェクト」が完成したわけではありません。

むしろ、まだまだ発展途上です。

やってみたいことは、いくらでもあります。

病院と地域の距離を、もっと縮めたい。

医療者と住民が、もっと自然に出会えるようにしたい。

学生や若い医療者が、地域の中で学び、育つ機会を増やしたい。

そして、医療者自身も、地域の中で生き生きと暮らせるようにしたい。

そんなことを考えていると、次から次へと新しいアイデアが浮かんできます。

困ったことに、賞をいただいたからといって、仕事が減るわけではなさそうです（笑）。

でも、それでいいのでしょう。

「いとち」は、完成された仕組みを守り続けるためのものではありません。

人が出会い、つながり、何かが生まれ、また新しい活動へと育っていく。

そんな、変化し続ける営みそのものなのだと思います。

賞状の先にあるもの

今回の受賞は、かしま病院だけの成果ではありません。

ともに活動を育ててきたヘキレキ舎の皆さん。

「いとち」に関わってくださった地域の皆さん。

さまざまな職種の仲間たち。

そして、これまで活動に参加してくれた学生や若い医療者たち。

多くの人たちの思いや行動が重なり合って、今回の評価につながりました。

心から感謝しています。

グッドデザイン賞2026。

本当にありがたい賞をいただきました。

でも、私たちが目指しているのは、賞状を飾ることではありません。

病院と街の間に、もっとたくさんの人のつながりが生まれること。

そのつながりが、誰かの健康や幸せを支える力になっていくこと。

そして、いつの日か、そんな光景が特別なものではなく、当たり前になっていること。

それこそが、私たちにとっての本当の「グッドデザイン」なのだと思います。

さて。

NHKホールという立派な舞台に立った「いとち」ですが、明日からの活動場所は、相変わらず、いわきの街です。

病院だったり、学校だったり、地域のどこかだったり。

華やかな照明も、レッドカーペットもありません。

でも、そこには人がいて、暮らしがあって、まだ見ぬ出会いがあります。

賞をいただいたから、次の一歩を踏み出すのではありません。

これまでも歩き続けてきたから、これからも歩き続けるのです。

さあ、次は街のどこで、何を始めましょうか。

どうやら「いとち」は、まだまだ面白くなりそうです。

（笑）

“Itochi” Takes the Stage at NHK Hall

— GOOD DESIGN AWARD 2026 and the Future Beyond

November 4, 2026.

Members of the Itochi Project gathered at NHK Hall in Shibuya, Tokyo.

The occasion?

The GOOD DESIGN AWARD 2026 ceremony.

Yes, our very own Itochi Project received the GOOD DESIGN AWARD 2026!

And what was recognized was not a medical device, a hospital building, or a new piece of healthcare technology.

It was something much less tangible—and, to us, much more meaningful.

The relationships we have been building between healthcare and everyday life in our community.

I must admit, it feels a little surreal.

For years, we have been experimenting, struggling, laughing, and occasionally wondering what on earth we were doing in the streets and neighborhoods of Iwaki.

And somehow, all of that led us to the grand stage of NHK Hall.

Life certainly has its surprises!

Were We Designing Something All Along?

The Itochi Project did not begin with the ambition of winning an award.

It began with a much simpler question:

What if healthcare could become a more natural part of everyday community life?

Instead of keeping healthcare confined within hospital walls, why not bring it into the community?

Instead of leaving healthcare professionals to think about health on their own, why not invite local residents to think alongside us?

Instead of focusing only on diseases, why not pay attention to the places where people live, the relationships they build, and the lives they lead?

These questions gradually shaped our activities.

Healthcare professionals began meeting local residents.

Students started learning directly from people in the community.

People from different professions came together, sometimes setting aside their job titles and professional boundaries to explore new possibilities.

And occasionally, we found ourselves involved in activities that were rather difficult to explain in conventional hospital terminology.

“Is that really something a hospital is supposed to do?”

A perfectly reasonable question!

But we have always believed that health cannot be created or sustained within hospital walls alone.

Health is shaped by everyday life.

By relationships.

By communities.

By the countless connections that make life meaningful.

That is why we have continued trying to bring healthcare into the places where people actually live.

And now, those efforts have been recognized as social design and community design.

Apparently, we had been designing something all along.

We just hadn't realized it!

We Never Set Out to Win an Award

This recognition has made me reflect on something important.

We did not connect with our community to win an award.

We simply kept building relationships—and somewhere along the way, what we were doing came to be recognized as “design.”

That is perhaps the simplest and most honest way to describe how I feel about this award.

Healthcare professionals step outside the hospital.

Community members become involved in healthcare.

Students learn from residents.

Young healthcare professionals grow, develop their own ideas, and begin creating new opportunities in other places.

Nobody is simply providing a service while everyone else passively receives it.

Instead, people influence one another.

Relationships develop.

New ideas emerge.

And gradually, something begins to change.

What we have been doing is not about designing objects.

It is about creating the conditions in which people can connect, participate, and grow together.

Of course, receiving the award is a tremendous honor.

We are delighted that the efforts of so many people have been recognized.

But what makes me happiest is something else.

The award has reassured us that the direction we have been pursuing is meaningful.

It feels as though someone has gently tapped us on the shoulder and said,

“Keep going. You're onto something.”

A New Perspective from NHK Hall

The members who attended the ceremony returned with wonderful stories about the atmosphere, the creativity, and the remarkable diversity of the award-winning projects.

The GOOD DESIGN AWARD celebrates much more than beautifully designed products.

It also recognizes initiatives that improve people's lives, strengthen communities, and create better ways for society to function.

Among the projects that particularly inspired our members was an initiative focused on creating a place of support and belonging for healthcare workers themselves.

Healthcare professionals spend their days caring for others.

They support patients.

They support families.

They support communities.

But who supports the people who provide that care?

Healthcare professionals are also human beings.

They need places where they can relax.

Places where they can connect with others beyond their professional roles.

Places where they can simply be themselves.

Perhaps even places where healthcare workers, patients, and community members can meet without the usual boundaries between those who provide care and those who receive it.

Imagine what might happen if such spaces became a natural part of community life.

This idea resonates deeply with the philosophy of Itochi.

Bringing healthcare into the community also means helping healthcare professionals rediscover their own place within that community.

The award ceremony was therefore more than an opportunity to celebrate what we had accomplished.

It became an opportunity to imagine what we might do next.

Itochi Is Still a Work in Progress

Receiving the GOOD DESIGN AWARD does not mean that the Itochi Project is complete.

Quite the opposite.

We are still learning.

Still experimenting.

Still making mistakes.

And still discovering new possibilities.

There is so much more we would like to do.

Bring hospitals and communities closer together.

Create more opportunities for healthcare professionals and local residents to meet naturally.

Help medical students and young healthcare professionals learn and grow through meaningful experiences in the community.

And create an environment where healthcare workers themselves can live fulfilling, connected lives.

The more we think about these possibilities, the more ideas seem to appear.

Unfortunately, winning an award does not seem to have reduced our workload.

If anything, it may have made us even busier!

But perhaps that is exactly how it should be.

Itochi was never intended to become a perfectly finished system.

It is a living, evolving process.

People meet.

Relationships form.

Ideas emerge.

New activities begin.

And those activities lead to still more connections.

The project grows because the people involved continue to grow.

What Lies Beyond the Award

This award does not belong to Kashima Hospital alone.

It belongs to everyone who has helped shape the Itochi Project.

Our partners at Hekirekisha.

The residents of Iwaki who have welcomed and supported our activities.

Our colleagues from many different professions.

The students and young healthcare professionals who have participated along the way.

And the many others whose ideas, enthusiasm, and generosity have helped turn small encounters into meaningful relationships.

To all of them, I offer my heartfelt gratitude.

The GOOD DESIGN AWARD 2026 is a wonderful honor.

But our ultimate goal has never been to display an award certificate on a wall.

What we truly hope to create is something much more important.

A community where meaningful connections between healthcare and everyday life continue to grow.

A community where those connections help support people's health, well-being, and happiness.

And perhaps, one day, a community where such relationships are so natural that nobody thinks of them as something special.

That, to me, would be the real meaning of good design.

And now, after standing on the magnificent stage of NHK Hall, where will Itochi go next?

Back to the streets of Iwaki, of course!

Back to our hospital.

Back to schools.

Back to neighborhoods.

Back to the places where people live, work, learn, and connect.

There may be no dazzling stage lights.

No red carpet.

No glamorous ceremony.

But there are people.

There are stories.

And there are countless possibilities waiting to be discovered.

We are not taking our next step because we received an award.

We received an award because we have never stopped taking those steps.

So, where in our community shall we begin our next adventure?

Something tells me that Itochi is only going to get more interesting.

And knowing our team, probably a little more unpredictable, too!

Stay tuned.

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 A One-Day Clinical Experience, a Lesson About the End of Life

 

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.

目指せ、家庭医療ジャングル！ Let's Grow a Family Medicine Jungle!

 

目指せ、家庭医療ジャングル！

長いこと、芽が出るかどうかも分からない種を、あちこちに蒔き続けてきました。

なかなか芽が出ないこともあれば、せっかく出た芽が枯れてしまうこともありました。

それでも諦めずに蒔き続けていたら、最近、どうも様子がおかしいのです。

蒔いた覚えのない場所から、思いもよらない形の芽が、勝手に顔を出し始めています。

いわきだけではありません。東京でも、あちらこちらでも。

しかも、かつて芽吹いた人たちが、今度は自分で種を蒔き始めている。

誰も頼んでいないのに、勝手に育って、勝手につながって、勝手に増えている。

実にけしからんことです（笑）。

でも、これこそが私たちの目指してきた姿なのかもしれません。

誰かが管理しなくても、それぞれが自分の場所で育ち、互いに影響し合い、新しい命を育んでいく。

一本の大木を育てるつもりが、いつの間にか森ができ始めていた。

だったら、もう遠慮することはありません。

病院の中だろうが、街のどこかだろうが、学校だろうが、商店街だろうが。

ところかまわず、家庭医療の種を蒔きまくってやろうじゃありませんか。

どんな芽が出るかは、育ってからのお楽しみ。

きれいに整列した人工林なんて、目指していません。

いろんな木があって、草があって、花が咲いて、ときには妙なキノコまで生えてくる。

そんな、雑多で、たくましくて、生命力にあふれた場所。

目指すは、家庭医療ジャングル！

もっとも、蒔いている本人が、そろそろどこに何を蒔いたか覚えていないのですが……。

まあ、いいでしょう。

勝手に芽吹くくらいが、ちょうどいい。

さあ、次はどこに蒔こうかな（笑）。

Let's Grow a Family Medicine Jungle!

— Keep Planting Seeds, and Let the Unexpected Happen

For years, we have been planting seeds of family medicine wherever we could.

Seeds that might sprout.

Seeds that might not.

Sometimes, nothing happened.

Sometimes, a tiny shoot appeared, only to wither away before it could grow.

Still, we kept planting.

We didn't always know whether our efforts would bear fruit.

But we believed that planting those seeds was worthwhile.

And so, we continued.

Lately, however, something rather strange has been happening.

Seeds are beginning to sprout in places where I don't even remember planting them.

And not just in Iwaki.

In Tokyo.

In other communities.

In places we never expected.

Even more surprisingly, people who once grew from those seeds are now planting seeds of their own.

Without being asked.

Without instructions.

Without anyone telling them what to do.

They are growing, connecting with others, and creating entirely new opportunities.

All on their own.

How wonderfully outrageous!

（笑）

But perhaps this is exactly what we have been trying to achieve all along.

Not a system that depends on one person constantly directing and managing everything.

Not a carefully controlled organization in which everyone must grow in the same direction.

Instead, a living network where people develop in their own ways, influence one another, and create new possibilities.

We thought we were trying to grow one magnificent tree.

But somewhere along the way, a forest began to emerge.

And if a forest is already growing, why stop there?

Let's turn it into a jungle!

Inside the hospital.

Outside the hospital.

In schools.

In shopping streets.

In cafés.

In neighborhoods.

Anywhere people live, work, learn, and connect.

Let's scatter the seeds of family medicine everywhere!

We don't need to know exactly what will grow.

That's part of the fun.

We are not trying to create a perfectly organized plantation, with identical trees standing neatly in straight rows.

We want something much more interesting.

Different trees.

Wildflowers.

Vines climbing in unexpected directions.

And perhaps even a few rather mysterious mushrooms appearing out of nowhere.

A place full of diversity, resilience, creativity, and life.

A place where unexpected encounters lead to new relationships.

Where people learn from one another.

Where healthcare professionals and community members grow together.

Where the ideas of family medicine take root far beyond the walls of any hospital.

Our goal?

A FAMILY MEDICINE JUNGLE!

Of course, there is one small problem.

The person who started planting all these seeds is gradually losing track of where he planted them.

But perhaps that doesn't matter anymore.

After all, the most exciting thing about a jungle is that it doesn't need someone constantly telling it how to grow.

It simply grows.

And grows.

And grows.

Sometimes, the best thing we can do is plant the seeds—and let life surprise us.

Now then…

Where shall I plant the next one?

遠くまで来て、身近な医療の意味を知る。 A Long Journey to Discover the Meaning of Medicine Close to Home

 

遠くまで来て、身近な医療の意味を知る。

――医学部2年生、たった一日の地域医療体験

11月2日、かしま病院に一人の医学生がやって来ました。

杏林大学医学部の2年生です。

今回の地域医療体験プログラムは、たった一日。

しかも、同級生のほとんどが大学近隣の医療機関を選ぶ中、この学生さんが選んだのは、東京からはるか遠く離れた福島県いわき市のかしま病院でした。

いやいや、どうしてまた、こんな遠くまで（笑）。

もちろん、来てくれるのは大歓迎です。

でも、わずか一日の実習のために、わざわざここを選んでくれた理由が気になります。

聞いてみると、お父様が高齢者を多く診る医療機関を経営されているとのこと。

そんな家庭環境もあって、何となくかしま病院に興味を持ち、足を運んでくれたようです。

何となく。

実は、この「何となく」という感覚が、私は結構好きなのです。

まだ明確な目標や答えがなくても、心のどこかに引っかかるものがある。

その小さな好奇心が、時として人生の大切な出会いにつながることがあります。

さて、そんな学生さんが、一日の実習を終えて書いてくれたアンケート。

これが、実に嬉しい内容でした。

---

■ 医師にとっては大勢の患者さんの一人。でも……

今回の実習では、外来での診察や入院患者さんとのコミュニケーション、リハビリテーションの様子などを見学してもらいました。

また、地域医療のあり方や、特別養護老人ホームなどの施設についても学んでもらいました。

実習後のアンケートには、特に印象に残ったこととして、こんな趣旨の言葉が綴られていました。

医師にとっては、日々診療する大勢の患者さんのうちの一人かもしれない。

しかし、その患者さんには、それぞれの人生があり、病気があり、さまざまな背景がある。

そして患者さんにとって、その医師は、自分の身体を診てもらう大切な存在なのだ、と。

私は、この感想を読んで、思わず嬉しくなりました。

医学部2年生。

これから解剖学や生理学、病理学、薬理学など、膨大な医学知識を身につけていく時期です。

しかし、この学生さんは、その前に大切なことに気づいてくれたようです。

医師にとっての「患者さんの一人」と、患者さんにとっての「自分を診てくれる医師」は、決して同じ重さではない。

医師は一日に何人もの患者さんを診察します。

けれども、患者さんにとって、その診察は一日の中の大きな出来事かもしれません。

診察室に入るまで、どれほど不安だったか。

家族に何を相談してきたのか。

医師の一言で、どれほど安心したり、逆に傷ついたりするのか。

診察室の中だけを見ていては、分からないことがたくさんあります。

だからこそ、私たちは病気だけでなく、その人の暮らしや人生にも目を向けたいと思っています。

---

■ 医療を教えたつもりが、病院の姿勢を見てくれていた

もう一つ嬉しかったのは、学生さんが医師の診療だけでなく、病院全体の雰囲気にも目を向けてくれたことです。

アンケートには、指導医だけでなく、スタッフの皆さんが親切に接してくれたことへの感謝も書かれていました。

これは、院長としてはかなり嬉しい。

いや、正直に言えば、医師の説明が褒められるより嬉しいかもしれません（笑）。

医学生の実習というと、どうしても指導医が何を教えるかに注目が集まります。

しかし、医療は医師だけで成り立つものではありません。

看護師、リハビリテーション専門職、薬剤師、医療ソーシャルワーカー、事務職員……。

さまざまな職種が、それぞれの立場から患者さんを支えています。

そして、その人たちがどんな表情で働き、どんな言葉を交わし、患者さんにどう接しているか。

学生さんは、そんな日常の姿からも医療を学んでいるのだと思います。

病院全体が、医学生にとっての教科書なのです。

---

■ 遠くまで来て、実は身近にあった医療の意味を知る

今回の学生さんのお父様は、高齢者を多く診る医療機関を経営されているそうです。

つまり、この学生さんにとって、高齢者医療はもともと身近な存在だったのでしょう。

けれども、身近にあることと、その意味を自分の言葉で理解することは、少し違います。

家族が携わっている医療。

日常のどこかで見聞きしてきた医療。

それが、遠く離れたいわきの病院で、患者さんや医療スタッフの姿に触れることによって、少し違った輪郭を持ち始めたのかもしれません。

実際、本人も今回の経験を通じて、何かが腑に落ちたようでした。

これは、なかなか面白いことです。

わざわざ遠くまで来て、初めて自分の身近にあったものの意味が分かる。

旅行でも、勉強でも、人生でも、時々こういうことがあります。

遠くへ行ったつもりが、実は自分の原点に近づいていた。

そんな一日だったのかもしれません。

---

■ たった一日で、何が教えられるのか

地域医療実習を受け入れる側として、いつも考えることがあります。

たった一日で、いったい何を教えられるのだろう。

医療制度を説明する。

地域の高齢化について話す。

診療を見学してもらう。

多職種連携の現場を見てもらう。

もちろん、どれも大切です。

でも、一日ですべてを理解することなどできません。

むしろ、私たちができるのは、学生さんの心に小さな種をまくことくらいなのかもしれません。

医療って、何だろう。

医師って、どんな仕事なのだろう。

患者さんを診るというのは、どういうことなのだろう。

そんな問いを一つでも持ち帰ってもらえたら、それだけで十分です。

答えは、これから何年もかけて、自分で見つけていけばいい。

そして、その答えは、医師になってからも変わり続けるものだと思います。

---

■ 地域医療の魅力は、地域医療の中にある

私たちは長年、地域医療の現場で医学生や研修医を受け入れてきました。

地域医療の魅力を、言葉で伝えようとすることもあります。

でも、結局のところ、一番伝わるのは現場そのものなのかもしれません。

患者さんとの何気ない会話。

スタッフ同士の自然なやり取り。

病気だけでは説明できない、その人の暮らし。

そうした日常の中に、私たちが大切にしている医療の姿があります。

今回の学生さんは、遠くからそれを見に来てくれました。

そして、何かを感じ取って帰ってくれた。

それが何より嬉しいのです。

最後に、アンケートの「実習中に困ったこと」という欄には、

「特になかったです。」

と書かれていました。

よかった、よかった。

遠くまで呼んでおいて、困ったことだらけでは申し訳ありませんからね（笑）。

そして、自由記載欄には、今回の実習への丁寧な感謝の言葉とともに、この経験をこれからの学びにつなげていきたいという思いが綴られていました。

こちらこそ、ありがとう。

数ある実習先の中から、かしま病院を選んでくれて。

たった一日のために、遠くまで来てくれて。

そして、私たちが日々大切にしているものを、こんなにも素直に受け止めてくれて。

医学生が何かを学んで帰るだけでなく、私たち自身も、自分たちの医療の意味を教えてもらう。

地域医療教育とは、案外そういうものなのかもしれません。

いつか医師になったとき、今回のいわきでの一日を、ふと思い出してくれたら嬉しいですね。

そのとき、どんな医師になっているのでしょう。

今から、ちょっと楽しみです。

A Long Journey to Discover the Meaning of Medicine Close to Home

— One Day with a Second-Year Medical Student

On November 2, a medical student came to visit Kashima Hospital.

He was a second-year student at Kyorin University School of Medicine in Tokyo.

His community healthcare experience would last just one day.

Most of his classmates had chosen medical institutions near their university. But this student decided to travel all the way to Kashima Hospital in Iwaki City, Fukushima Prefecture.

That is quite a journey for a single day of clinical observation!

Naturally, we were delighted to welcome him.

But I couldn't help wondering:

Why on earth did he choose a hospital so far away?

When I asked, he explained that his father runs a medical institution that cares for many elderly patients.

Perhaps because of that family background, he had developed a vague interest in Kashima Hospital and decided to visit.

A vague interest.

I rather like that expression.

Sometimes, we don't need a clear objective or a carefully planned career path to take an important step.

A small curiosity can lead us somewhere unexpected.

And occasionally, it can change the way we see the world.

After completing his one-day experience, the student filled out our feedback questionnaire.

His reflections were truly encouraging.

---

One Patient Among Many — But One Doctor Who Matters

During his visit, the student observed outpatient consultations, communication with hospitalized patients, rehabilitation, and various aspects of our daily clinical practice.

He also learned about community healthcare and the role of residential care facilities for older adults.

In his questionnaire, he reflected on something that had particularly impressed him.

For a physician, a patient may be one among many people seen throughout the day.

But every patient has a unique life, personal circumstances, medical history, and individual concerns.

And for that patient, the physician examining them may be someone on whom they place enormous trust.

Reading his words made me genuinely happy.

Here was a second-year medical student, still at the beginning of his medical education, already recognizing something essential about being a doctor.

For a physician, someone may be one patient among many. But for that patient, the physician may be one of the most important people in their life at that moment.

Doctors see many patients every day.

But for each patient, a medical appointment may be a major event.

How anxious were they before entering the examination room?

What conversations did they have with their family beforehand?

How much reassurance—or distress—might a physician's words bring?

There are countless things we cannot understand simply by looking at a disease.

That is why we believe medicine must consider not only illness, but also the person living with it.

Their family.

Their circumstances.

Their everyday life.

Their story.

---

The Hospital Itself Is a Classroom

Another part of his feedback made me particularly happy.

The student had noticed not only the physicians and their clinical work, but also the atmosphere throughout the hospital.

He expressed appreciation for the kindness of our staff and the warm welcome he had received.

As hospital director, I must admit that this was especially gratifying.

Perhaps even more gratifying than receiving praise for the doctors!

(Please don't tell my colleagues I said that.)

When we discuss medical education, we tend to focus on what supervising physicians teach.

But healthcare is never delivered by doctors alone.

Nurses, rehabilitation professionals, pharmacists, medical social workers, administrative staff, and many others all contribute to patient care.

And students learn by watching how these professionals interact.

How they speak to patients.

How they support one another.

How they respond to difficulties.

How they create an environment in which patients feel safe.

These everyday interactions teach lessons that cannot always be found in textbooks.

The entire hospital is a classroom for future healthcare professionals.

And sometimes, the most important lessons are taught without anyone realizing they are teaching.

---

Traveling Far Away to Understand Something Close to Home

The student's father runs a medical institution that cares for many older adults.

In other words, healthcare for elderly people was already a familiar part of his world.

But being familiar with something is not necessarily the same as understanding its meaning.

Perhaps he had grown up hearing about his father's work.

Perhaps caring for older patients had always seemed like a natural part of medicine.

Yet during his visit to a hospital far from home, something appeared to fall into place.

By observing patients, physicians, and other healthcare professionals, he began to recognize the deeper significance of the kind of medicine that had long been close to him.

There is something rather wonderful about that.

He traveled a considerable distance, only to discover something meaningful about his own familiar world.

Sometimes, traveling far away helps us understand what has been right beside us all along.

We may think we are exploring somewhere new.

But perhaps we are also discovering something about where we came from.

For this student, his journey to Iwaki may have been just such an experience.

---

What Can We Really Teach in Just One Day?

Whenever we welcome medical students for short clinical experiences, I find myself asking a question.

What can we possibly teach someone in a single day?

We can explain Japan's healthcare system.

We can discuss population aging and the challenges facing local communities.

We can introduce multidisciplinary collaboration.

We can show students how outpatient care, hospital medicine, rehabilitation, and community services connect.

All of these are important.

But no one can fully understand community healthcare in just one day.

Perhaps our role is not to provide all the answers.

Perhaps it is simply to plant a small seed.

What does it really mean to practice medicine?

What kind of physician do I want to become?

What does it mean to care for a person rather than merely treat a disease?

If a student leaves our hospital carrying even one of these questions, I believe the experience has been worthwhile.

The answers can come later.

Over years of study.

Through encounters with patients.

Through mistakes, challenges, and unexpected discoveries.

And even after becoming a physician, those answers will continue to evolve.

I certainly know that mine have.

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The Best Way to Discover Community Medicine Is to Experience It

For many years, Kashima Hospital has welcomed medical students and residents into our community-based healthcare environment.

We often try to explain why community medicine matters.

We talk about continuity of care, comprehensive care, collaboration, and the importance of understanding people's lives.

But perhaps the most convincing explanation is not something we say.

It is something students see.

An ordinary conversation with a patient.

A nurse quietly helping someone feel comfortable.

A rehabilitation professional encouraging a patient to take another step.

A physician listening carefully to a concern that cannot be explained by laboratory results.

A team working together to support someone returning home.

These everyday moments reveal what we value.

And this student traveled all the way from Tokyo to experience them.

He came with curiosity.

He left with something to think about.

That alone makes us happy.

Incidentally, our questionnaire also asks students whether they experienced any difficulties during their visit.

His answer was wonderfully straightforward:

“Nothing in particular.”

Excellent!

After asking someone to travel such a long distance, the last thing we would want is for the experience to be filled with problems.

At least we managed to avoid that!

In the final section of his questionnaire, he expressed sincere gratitude for the opportunity and wrote about his desire to carry what he had learned into his future medical education.

But the gratitude is mutual.

Thank you for choosing Kashima Hospital among so many possible destinations.

Thank you for making such a long journey for a single day.

And thank you for recognizing something meaningful in the ordinary work we do every day.

Medical students come to our hospital to learn. But sometimes, through their reflections, they remind us why our own work matters.

Perhaps that is one of the most rewarding aspects of medical education.

I hope that someday, after he becomes a physician, this student will remember his brief visit to Iwaki.

Perhaps a conversation, a patient's expression, or a small moment from that day will come back to him.

And perhaps it will help him make a decision when he needs it most.

I wonder what kind of doctor he will become.

I am already looking forward to finding out.

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At Kashima Hospital, we believe that community healthcare is not simply about treating diseases. It is about understanding people, their lives, and the communities in which they live.

And sometimes, even a single day is enough to begin understanding what that means.