「できない理由」より、「どうすればできるか」 Not “Why We Can't,” but “How We Can”

 

医療を街に置く ― かしまモデル 二十年の軌跡 ―

第51話　「できない理由」より、「どうすればできるか」

震災直後。

かしま病院は約1か月にわたり断水しました。

手術室は使えません。

透析もできません。

建物の継ぎ目は裂け、青空が見えていました。

普通に考えれば、

「できないこと」を並べる方が簡単な状況でした。

それでも、

病院は止まりませんでした。

外来は閉鎖しました。

しかし、

受付には医師が座りました。

薬だけでも届けよう。

困っている人を帰さないようにしよう。

住宅が被災し、

薬手帳も薬袋も流されてしまった患者さんには、

「何もなくても大丈夫。一緒に考えましょう。」

そう声を掛けました。

救急も同じでした。

これまでのように、

「受け入れられるか。」

を考えるのではなく、

「受け入れるためには、どう動けばいいか。」

を皆で考えました。

その積み重ねが、

後のかしま病院の文化になりました。

---

2026年の私より

私は今でも、

病院で何か新しいことに挑戦するとき、

まず一つだけ確認します。

「できない理由」を探していないか。

もちろん、

安全性は何より大切です。

法令も守らなければなりません。

しかし、

その上で、

本当に患者さんや地域のためになることなら、

「どうすれば実現できるか」

を考える病院でありたい。

この文化は、

会議室で生まれたものではありません。

震災という極限状態の中で、

職員一人ひとりが、

目の前の患者さんのために考え抜いた結果、

自然に育まれたものです。

だから私は、

今も職員に伝えています。

「できない理由ではなく、どうすればできるかを一緒に考えよう。」

それが、

かしま病院の文化です。

そして、

かしまモデルの原点でもあります。

Bringing Healthcare into the Community

The Kashima Model: A Twenty-Year Journey

Episode 51 – Not “Why We Can't,” but “How We Can”

The Great East Japan Earthquake.

Typhoon Hagibis in 2019.

The COVID-19 pandemic.

Three major disasters tested Kashima Hospital over the course of fifteen years.

Each one challenged us in different ways.

Yet together, they shaped something far more enduring than emergency preparedness.

They shaped our culture.

---

Immediately after the earthquake,

our hospital lost running water for nearly a month.

The operating theatres became unusable.

Dialysis services had to be suspended.

The force of the earthquake tore open the expansion joints between buildings so widely that daylight could be seen through the cracks.

Only weeks later,

powerful aftershocks struck again.

Just as the water supply had finally been restored,

it disappeared once more.

Under such circumstances,

it would have been easy to list all the reasons why we could not provide medical care.

Instead,

we asked a different question.

"How can we?"

Routine outpatient services were suspended.

But treatment did not stop.

Physicians sat at the reception desk,

continuing to prescribe medications for patients who had nowhere else to turn.

Many had lost everything.

Their homes.

Their belongings.

Even their medication records.

We often told them,

"Bring anything that might help—a medicine bag, an empty blister pack, even just your memory."

"And if you have nothing at all, we'll work it out together."

That spirit reached beyond the outpatient clinic.

Until then,

the decision to accept an ambulance had largely depended on the judgement of a single physician.

The earthquake forced us to rethink that approach completely.

Instead of asking,

"Can we accept this patient?"

we began asking,

"What must we do so that we can?"

Every physician.

Every nurse.

Every pharmacist.

Every therapist.

Every member of the hospital.

The entire organisation moved with the same purpose.

As a result,

our ambulance acceptance rate, which had previously remained around fifty percent,

rose dramatically,

approaching one hundred percent.

---

Reflection from 2026

Even today,

whenever we face a new challenge,

I ask our staff one simple question.

"Are we looking for reasons why we cannot?"

Or,

"Are we looking for ways to make it possible?"

This does not mean ignoring safety.

Nor does it mean disregarding professional standards.

Healthcare must always remain safe, ethical, and evidence-based.

But once those principles are secured,

our responsibility is to think creatively,

collaborate,

and find a way forward.

That culture was not created in a boardroom.

It was born during one of the darkest periods in our hospital's history.

It grew from countless ordinary people doing extraordinary things for the patients standing before them.

Looking back,

I realise that the Kashima Model did not begin with a project.

It began with a question.

Not,

"Why can't we?"

But,

"How can we?"

That question continues to guide us today.

And I hope

it always will.