Japanese Surgeon's Daily Life

Crane Climbing

　　My workplace is located on the waterfront facing the Seto Inland Sea and two huge jib crane towers are there. I was wondering if I could climb up to the level of the operation booth to see how it works and if the operator climbs down every single time he/she does business, or if the crane itself is equipped with a restroom. When I asked a veteran worker about the question, he advised me to go up to the operation booth by myself some day.
　　This morning he came to my office and told me that one of the two cranes is out of work today and he can show me the crane right away. It's a really peaceful day without a strong wind. I was happy and followed him, but it was only a third of the height of the operation booth that I could reach. As you imagine, I was scared. It was clear and brilliant with a mild breeze. The view was great but the stairs were wild and exposed. I would need to become habituated to the height. I was resolved to climb up to the operation booth next time and went down with extreme care.
　　The following picture was shot on the highest point I got to today. My company is a company complex and I'll show you the website of this company, Material Handling Systems, below.

https://www.shi.co.jp/shi-mh/english/product/jibcrane.html

勤務している工場群は瀬戸内に面した海岸にある。そこにクレーンが二基そびえている。前々から登ってみたいと思っていた。このクレーンを操作する人はトイレのたびに降りてくるのだろうか。上り下りが大変だろうと思っていた。それとも、上にトイレがあるのだろうか、、、、

ベテラン作業員が健康相談室へやって来た。今日は一基が稼働せず、また風邪の無い日だったので案内するという、、、。早速同行したが登れたのは約１／３の高さまでだった。怖くなって途中で断念。微風ではあったが、外へむき出しの階段はスリルがあった。てっぺんまで上がるのには慣れが必要だろう。次回こそはと心に決めて退散した。

What I Think Now

　　Almost two months have passed since I finished my career as a general surgeon and started my second life as an industrial physician. I've been on a steep learning curve during these two months. The differences in manners and customs generating from the different business world are very exciting. The injuries and illnesses incidents to jobs are strictly supervised by the government and workers are protected from those with great care. I knew about that after taking up this profession. I wonder if other countries are like this. I often see the pictures of workers in many developing countries in National Geographic, and I feel that Japanese workers are blessed.

(Vocabulary)
I've been on a steep learning curve 　短期間に多くのことを学びました。

３５年間の外科医生活にピリオド。そして産業医となってもうすぐ２ヶ月。この短期間に多くのことを学んだ。業界の違いによる風習の違い、興味深い。仕事が原因となり引き起こされる病気や怪我。それに対して、国が労働者にいかに手厚い保護をしているか、よくわかった。どの国も同じような感じなのだろうか？愛読しているナショジオで海外の労働者の写真を良く見るが、日本の労働者は恵まれている気がする。

 

Outfit 2 Safety Gaiters

　　The picture shows my safety gaiters, which are also given to me. The workers have to wear this outfit to fix the ends of their trousers at work. When I visit their workplaces, I'm supposed to use these gaiters. If the ends of the trousers are free, it might touch and turn something over or might become the cause of the workers' fall. Very often serious accidents can happen from trivial carelessness. Let's take care.

きゃはん（脚絆）

写真は脚絆。足首に巻いてズボンの裾がパタパタしないようにする道具。何かに引っかけたり、あるいは自身の転倒防止のためである。小さな不注意が原因で大事故が生じることもある。気をつけよう。

Outfit 1 Safety Belt

　　The safety belt, which workers are strictly required to wear when they work over 1.5 meters high, was given to me. I think that the height of 1.5 meters is not so dangerous, but a blow to the wrong spot can be fatal even if one fell down from 1.5 meter's height. Some workers are reluctant to wear the belt from laziness. Making them wear the safety belts properly is also my task. Anyway, considering the delivery of it to me, does it mean that I have to go up to such places?

(Vocabulary)
outfit （特別な場合･職業に用いる）道具類一式, 装備一式,七つ道具
a puncture repair outfit パンク修理工具一式.

安全帯

１．５メートル以上の高さで作業をするときに必ず付けることになっている安全帯。１．５メートルくらいなら問題ないと思うが、打ち所が悪ければ重大な結果になるだろうから当然か。作業員の中にはめんどくさがって付けない者がいる。彼らにしつこく忠告するのも僕の仕事。高いところは苦手だが、写真は先日僕に届いた安全帯。これをつけて行かなければならない箇所があると言うことだろう、、、、(^_^;)

Paint Shop

　　The paint shop stank with the smell of thinner or organic solvent. The following picture was shot just after coming back to my office after inspection. I took my safety work shoes off and I'm relaxed. I'm hanging a gas mask from my neck. Wearing this mask in the shop, the bad smell disappeared. The function of the mask was awful. In the shop, several workers were painting a huge object, which might be a part of a big structure, but I didn't figure out what it was. The workers were well protected from poisonous chemicals. My job is to check their working circumstances and detect the hidden danger. Their annual general health check is also my job. Most workers of this shop were young. I'd like to contribute to my company by keeping them healthy.

塗装工場ではシンナーの臭いが鼻についた。下の写真は巡視から帰ってきて靴を脱いでリラックスしているところ。首からぶら下げているのはガスマスク。これを付けるとシンナーの臭いをまったく感じなくなった。素晴らしい能力を持ったマスクだ。工場では数名の作業員が巨大な構造物（の一部）を塗装していた。もちろん、有機用剤の影響を避けるための防護はしっかりとなされていたが、彼らの作業環境を確認し、隠れている危険を察知することが僕に課せられている仕事。また、定期的に彼らの健康診断もしている。若い人が多かった。彼らが定年まで安全に健康に過ごせるよう頑張っていきたい。

Sandblasting Shop

　　I perceived directly the technology called sandblasting today. It's one of the polishing methods to blast small particles such as sand or something against the surface of the material. It naturally generates unnecessary dust which could cause dust pollution or health damage. The workers wear an airline respirator to avoid inhaling the room air and perform their task in a perfectly closed space. I inspected the scene today. When I visited the shop, their work had just started and I wasn't able to look at their work live. Their work condition is really harsh, but occupational hazards or accidents at work never happen. It's my present job to keep workers away from those misfortunes. Hearing the noise from their blasting work, I moved to the adjacent painting shop.

 

研摩工場

サンドブラストという技術を初めて知った。物質の表面に砂などの研摩材を吹き付ける加工法で、当然ながら粉塵が舞う。作業者はエアラインマスクを装着し、完全に閉じられた場所で作業を行う。今日はその現場を視察した。行ってみると、ちょうど作業が始まったばかりで中への立入は出来なかった。過酷な環境での仕事だが、絶対に健康障害を起こしてはならない。それが僕の今の仕事。サンドブラスト中の激しい音を聞きながら隣の塗装工場に移った。

35 Years After The Crash Of A Jumbo Jet In Japan

　　35 years have passed since the last passenger plane crash in Japan. I was living in Osaka as a first-year resident at that time. I started my career in April and knocked myself out. My colleges and I were allowed to go downtown for a party on the day for the first time. Just before the opening, a message from the office was passed down by one of my colleges who arrived a little late. (Smartphones didn't even exist yet on the globe in those days.)
　　We were told not to drink alcoholic beverages. A fully-occupied jumbo jet bound for Osaka from Tokyo had gone missing several dozen minutes before, and if the plane was found near Osaka, we would be some help for its passengers, even though we were green. I remember what happened on the day just like yesterday. 35 years as a general surgeon looks a long time, but it passed in a flash. As far as my physical strength lasts, I'll persist with health care for the public.

(Vocabulary)
persist with sth ＜…＞をあくまでもやり続ける
Anna persisted with her studies in spite of financial problems. アンナは経済的な問題にもかかわらず，くじけずに学問を続けた．

8/12 ジャンボジェット機墜落から35年
　日本で起こった最後の旅客機事故から今日で３５年になる。当時、僕は大阪で一年目の研修医生活を送っていた。４月から勤務し、毎日毎日仕事に追われ、８月１２日、職場の仲間で初めて飲みに出た日、乾杯の直前、遅れてやって来た仲間から病院からの指示が伝えられた。(当時は携帯電話という便利なものは無かった。）
　アルコールを控えるようにと言う指示だった。東京から大阪に向かっていたジャンボジェットの消息が途絶えた。救援依頼がいつ来るかもわからない。その日のことを昨日のことのように覚えている。あれから３５年。長いようであっという間の医師人生だった。これからも体力の続く限り、社会に貢献していきたいと思っている。

Reunion

　　I wrote about my old friend living on this island in the previous entry. We visited a ramen restaurant run by his brother. When we met in the hospital after a 30 years' interval, he and I were on duty, so we made a promise to meet somewhere out of the hospital. He, his wife, my wife and I had a very happy time over his brother's local cuisine. If he hadn't been on the island, I'd not have visited the island. We parted after another promise to see each other again.

旧友と約束をしていたため指定の場所へ移動。実兄が経営するラーメン屋でランチ。懐かしい話に花が咲いた。約30年ぶりの再会である。彼がいなかったら種子島へは来ていなかったと思う。食後、再会を期して別れた。

Dialysis Room

　　Everything starts early in the dialysis room. Staff members start preparation of the circuit, called priming, at 6 o'clock if not sooner. I visited the room after their priming work and before patients came in to see and say hello to my old friend and instructor at the same time. To tell the truth, a medical engineer who worked in this dialysis room used to be my instructor of dialysis, though he was a little younger than me. He reached the officially-set retirement age last year, but was still exceptionally working, his experience being rated highly. We took pictures for our shared friends in the dialysis room.
　　About 30 years ago, we had climbed the famed Hotaka mountains, ascending via Karasawa valley, standing at the summit of Mt. Okuhotaka, then descending to Kamikochi. I remembered our climbing just like yesterday. Not having enough time for chatting, we promised to meet with both wives somewhere outside the hospital.

(Vocabulary)
Dialysis Room 透析室
circuit 透析回路
if not sooner 遅くとも




透析室の朝は早い。６時頃には午前の透析のためのプライミングが始まる。この透析室に僕が２０代の頃、透析を習ったＭＥが務めている。昨年で定年になったのだが、経験を買われて今も勤務している。数日前に３０年ぶりの再会をし、当時の仲間に見てもらうために写真を撮影。彼とは穂高に一緒に登ったことがある。涸沢から上り、奧穂高へ登頂して上高地へ下山。実に懐かしい。職場ではゆっくり話が出来ないので、島を離れる前にどこかで会う約束をした。

Vegetation

　　Today is July 24th. I looked out of the window after the evening shower. There's no high mountain and the vegetation around was different from my hometown. I'd like to go and see the island, but I had to stay in the hospital a few more days.

(Vocabulary)
vegetation (集合的に) 植物, 草木,植生





今日は２４日、夕立の後、外を眺めた。高い山がない。そして植生は明らかに愛媛県とは違う。早く街を探検してみたいが、あと数日の勤務がある。

Ask For Help

　　About half a year ago, I was asked to work for a few days from a municipality operating hospital on a small island located to the south of Kyushu. That island, Tanegashima, is badly off for doctors, and they wanted me to stay at the hospital for four days in July. They'll offer transportation expenses except my salary. The best thing was that I was able to see one of my old friends living on this island. I decided to accept this offer promptly and I was looking forward to the day.
　　Hearing the name of the island, average Japanese people recall the rocket launching site and guns. Tanegashima has two images of cutting-edge technologies and its glorious history. I'll write about my two weeks' trip to Tanegashima, which is called the closest island to the universe.

　半年ほど前、九州の南に浮かぶ小さな島の病院から救援依頼が来た。元々医師の少ない島であるが、医師不足のため7月の半ばに4日ほど勤務して欲しいという。その島は種子島。給料をもらい、往復の運賃も支給される。そしてこの島には研修医時代に苦楽を共にした仲間がいる。彼らにも会いたい。即断した。そしてその日がやって来た。
種子島と聞いて平均的な日本人なら、ロケットと鉄砲を思い浮かべるだろう。最先端技術と古い歴史の同居する島。観光もしてみたい。しばらく、宇宙に一番近い島と言われる種子島の旅行記を綴っていく。

New Work

　　When I work as an industrial physician, psychosomatic knowledge is essential. Some people are suffering from mental disorders and can't engage in their work. The industrial physician has to help them come back to their work in cooperation with their doctors and company staff members. However, I have little experience about the therapy of mental disorders, so I decided to work as a physician at a hospital caring for patients with mental disorders once a week. I have worked on the front line of the emergency medical service for 35 years. I can cope with a variety of situations which require prompt treatments like surgeries in the head, chest, abdomen, and what's more, delivery, renal dialysis, and so on. I can deal with almost anything which needs urgent measures. However, I'm an ordinary man in the field of psychiatry and psychosomatic medicine.
　　If I work in a psychiatric hospital even one day in a week, I can, I thought, frankly ask questions I feel in my work as an industrial physician to professional psychiatrists for instance during lunch time. I would be able to see their consultation or get something in the conferences between professionals. You might say, "You should learn them by yourself!" I believe, it's correct, but I would lose my patience in such a way, and I'm going to learn professional techniques in the way of a shop boy near a temple.

(Vocabulary)
以下全て、『門前の小僧習わぬ経を読む』
A shop boy near a temple will recite the scriptures untaught.
You learn, without realizing it, from what is around you.
A saint's maid quotes Latin.
The sparrows near the school sing the primer.

産業医をするにあたり、心療内科の知識が不可欠と聞いているので、週に１日、精神科、心療内科を標榜している病院に内科医として勤務することにした。これまで救急医療に携わってきた。専門領域の境界を越えて、緊急で行わなければ救命できないような状況に対応するため、開頭、開胸、開腹、お産や透析、心カテなど、およそ緊急性が問われるものにはたいていのことに対応できる。が、心療内科や精神科だけは経験が無いのだ。

産業医業務の中で生まれた疑問点をランチをとりながら専門家に気軽に尋ねることが出来るし、専門家の診察を見学したり、専門医同士の会話の中に得るものが多々有ると思う。自分で勉強すれば良いのだろうが、根気が続かないだろうと思われ、『門前の小僧』方式で学ぶつもり。

Disposal of Record of My Resident Days

　　I'm starting writing about my resident days, the story of about 30 years ago. I was being required to complete the progress summary of every inpatient in my charge just after their discharge. I found it too much trouble to organize them as I had to care for other new patients or being transferred to my office one after another.
　　The summary paper consisted of three sheets and when you write on the 1st sheet, your writing is duplicated on the 2nd and 3rd sheets. The 2nd sheet was supposed to be filed into the medical record in the term of the hospitalization and then it was to be archived. The 3rd one was inserted into the opd chart for following-up on the post-discharge patient. Then the 1st one was kept by a doctor in charge.
　　When I finished the resident term, the head doctor told me to privately keep the summaries from then on until when I'll stop working as a doctor never to lose my initial enthusiasm toward medicine by reading them from time to time. I've actually followed his words for more than 30 years. I recalled those days nostalgically and have often felt that the current medicine would have saved some of the departed.
　　I shredded a bunch of them today. I was able to remember some of them, but most of the patients had disappeared from my mind. The patients whose faces I remembered were mostly those who had passed away in my presence. All of them educated me as a clinician. I have no words to express my gratitude to them.
　　I'll start a new chapter of my life as an industrial physician in August. I don't know what I can do or can't do, but I can declare that I will do my best.

研修医時代、自分の受け持った患者の入院記録をまとめる義務があった。通常の仕事の傍ら、記録をまとめることは面倒な仕事だった。記録用紙は３枚綴りの複写式になっていて、二枚目を入院カルテに、三枚目を外来カルテに閉じ、一枚目は自分で保管することになっていた。

研修医生活を終えるとき、院長の挨拶があった。その中で、サマリーは医業を終えるまで保管し、初心を忘れぬよう、折々に読み返すよう勧められた。そして、実際にそうしていた。３０年前の病院の様子が懐かしく、また今ならこの患者を救うことが出来たのに、、、と残念に思うこともたびたびあった。そのサマリーを今日処分した。思い出せる患者もいたがほとんどは記憶にない。全てが医師としての自分を育ててくれた人たち。

Industrial Physician

　　I've been working as a general surgeon for more than 30 years tasking my energies to do numerous surgeries and care emergency cases. However, I'm thinking about retirement from the front line. Not only due to the physical strength, but I became eager to have time to enjoy my own life. In general, Japanese surgeons don't have enough time to do so. Then, what do I do since now.
　　The easiest way is to shrink the amount of work in my present office, but I thought that it's not bad to challenge something new to me. It would help mitigate against my aging. It might be stressful for my age to start a new job, but my curiosity seemed to be still alive. I chose the way to an industrial physician in one of the representative industries of Japan.
　　I would never be called from the emergency room and be able to take day-offs according to the calendar. I wouldn't need to come to my office during holidays. I would be free from the care of inpatients. I would have to change the title of my blog to insert "former" before "Japanese". One thing, the skills which I acquired with difficulty must be still useful and I'm visiting some hospitals to help other doctors.

(Vocabulary)
task one's energies 全力を傾ける

これまで30年以上、外科医として勤務してきた。数々の手術、救急医療に携わってきたが、そろそろこの辺りで第一線から引こうと思う。体力的なこともあるが、時間が欲しくなった。日本の外科医は自由な時間が少ない。
今の勤務先で仕事を縮小するのが一番楽な生き方だが、新しいことに挑戦するのも悪くないと思い始め、産業医を志すことにした。この歳で新しいことを始めるのは苦労するだろうが、老化を抑制することになるだろう。

緊急事態での呼び出しはないし、カレンダー通りの休みとなる。また勤務先は大手の企業であり、組合の規定通りの休みも取れる。このブログのタイトルは元外科医の～と変えなければならないが。ただ、折角身につけた技術を無駄にもしたくない。時々、民間病院に出かけていって診療の手伝いもしたいと思っている。

The Second Wave

　　The number of people newly infected with Wuhan virus is being reported every day and its number is decreasing in Japan, but the second wave of prevalence is said to be coming soon. The second wave is actually a fear, but Japan started to cautiously proceed to the way of revival. Authorities issue various political measures to stimulate the economy.
　　As one of the revival policies, my prefecture is issuing discount coupons for accommodations to welcome tourists from across Japan. My wife and I decided to stay at a gorgeous traditional Japanese-style inn, "Ryokan" in Japanese, using the prefecture-issue coupons. The inn is located at the hot spring area in my hometown. Though it is in my hometown, we've never stayed at it. I'd like to enjoy Japan's oldest hot spa, Dogo Onsen, in the beginning of July. If I'm allowed to take pictures inside, I'll upload here. If you don't experience Japan's "Ryokan", I'll advise you to stay at them by any means.

 

Heartful Supply

　　Today, we, health care personnel received an unexpected supply of refreshments from a local dairy company. While cows produce milk, all the schools are closed due to the Wuhan virus and their products lost most part of the demand. The company leaders seemingly wanted to show thanks to medical personnel occupied with the extra task to prevent patients from the Wuhan virus infection. In this rainy season of two years ago, this company transported fresh water to my office by their milk truck, when the region suffered from a big flood damage. My office wasn't damaged on the basis of hardware, but the water supply was cut. The milk truck transported water for the bath. Not only the inpatient but also the neighborhood were able to be refreshed through the bath.

(Vocabulary)
provision [C,U] (必要品・サービスなどの) 供給, 支給
a supply of refreshments to a person occupied with some task　差し入れ

Ozu Shrine

　　I wondered how many shrines there are in Japan. I found a shrine in the neighborhood of a hospital which I visited for assistance with surgery today. The shrine's name was Ozu Shrine. Its description says, it is said to have been built more than 1000 years ago and its accurate historical records have been preserved since the latter half of 15th century. Knowing that, I understood its sublime atmosphere. After some relocations, it was settled in the former Ozu village. "Zu" in the name of the village means a port. This place used to face the ocean before massive reclamation work and the shrine was expected to protect people from maritime accidents.
　　A renowned Japanese physicist and essayist at the same time, having been born in this city, seemed to frequently visit the shrine in his childhood. His museum apparently exists in the neighborhood. I'm going to drop in at the museum next time. The shrine is located in the center of Kochi city now, but it was surrounded by forest and calm. I was able to concentrate and brace myself for the surgery.

小津神社

一体日本にはどれだけ多くの神社があるのだろうか？今日も応援に来た病院の周辺を散策中に立派な神社を発見した。小津神社という。沿革を読むと、創建は１０００年以上前で正確な記録が残っているのは１５世紀後半から。数回の移転を重ね、小津村に鎮座。津という漢字は港を意味する。この場所に鎮座した頃はこの地は海に面しており、海の安全を守る神様として鎮座したと伝わる。

この地の出身の有名な物理学者、随筆家が子ども時代に足繁く通ったという記録もあった。高知市のど真ん中に位置しているが、森に囲まれ、ピンと張り詰めた静けさの中で数時間後に始まる手術に向けて、精神集中、気を引き締めることが出来た。

N95 Mask

　　Vicious Wuhan virus prevails around the world. I'm angry that China and WHO didn't take stern measures to confine it and stop spreading it. Lots of people, including my favorite comedian, who didn't need to die passed away. However, it's no use crying over that now.
　　The prevalence of Wohan virus is not so heavy in my hometown compared with Tokyo, but health care facilities are likewise fewer. Even a small localized epidemic would lead to a serious situation. Health care personnel are required to expect the worst-case scenario.
　　When I tidied up my room, a box of N95 masks came out. A few dozen masks were left in the box. I recalled that the local government or my office had offered it to medical personnel during the SARS pandemic back in 2003. Its expiration date for use is in 2013, but it would be no problem in daily life not for medical use even now. I'm using this in my daily commute.

武漢ウイルスが世界的に蔓延している。早期に手を打たなかった支那やＷＨＯに怒りを覚えるが、今それを言ったところで仕方がない。このあたりでは武漢ウイルスの広がりは東京ほどではない、しかし、東京に比べ医療機関が少ないから、一度感染が拡がったら医療崩壊を起こすだろう。考えられる限りの対策を講じておこう。部屋の片付けをしていたらＳＡＲＳパンデミックの時に用意していたＮ９５マスクが大量に出てきた。使用期限は切れているが、通勤時にはこれを使うことにしよう。

Driving in Mountainous Region

　　Fun driving on my way home after the technical assistance of a surgery in a hospital located in a rural area --- I made a detour to look around in the central area on Shikoku island. The sun rose higher in the cloudless sky. My car doesn't generate unpleasant noise except the wind noise being driven by electricity. When I opened windows, the sound of wild birds came in --- the experience only in the cars without combustion engines.
　　Pulling over my car, I looked down from the road shoulder. A narrow river was running. I didn't know its name, but it surely was one of the tributaries of Niyodo river, which is renowned for its transparency and color called "Niyodo Blue".
　　By the way, did you notice a small shabby bridge over the river? This type of bridge is generally called chinkabashi, which means literally "sunken bridge". This type of bridge indicates that the stream often changes into a torrent. This bridge is designed to avoid the strong pressure from the current even in a swift stream. That's why it has no bridge-rail. When the water increases and the current becomes rapid, the bridge get sunken and avoids being destroyed. It's the collected wisdom of many centuries.

山の中のドライブ

手術応援からの帰り、山の中をドライブ。天気が良くて、快適なドライブとなった。車の騒音がないので窓を開けていると野鳥の鳴き声が聞こえてくる。電気自動車ならではのことだ。道路脇に車を止めて川を覗き込むと沈下橋が見えた。何の飾りもない、手すりすらない石橋だ。水量が増えても水の流れに逆らう部分を極力なくしたこの形は橋が流されることを防いでいる。この川は美しい水、景色で知られる仁淀川の支流で、最近は外国からカヌーイストもやってくると聞く。たまにはこういう田舎のドライブも楽しい。

Frost

　　I came to a hospital in the mountainous region in Shikoku to assist a major surgery. After that, I stayed overnight at the hospital to observe the postoperative course and I went out of the building to feel fresh air in the mountains in the early morning. Then I found my car frosted over. I was truly in the midst of Shikoku mountains as you would expect. I had something on my mind when I bought my car driven by electricity. It has no combustion engine and might be weak at warming itself. I was surprised to see my car and I went back in the building and turned the defroster on 30 minutes before departure via internet. The frost had already disappeared when I got to my car. What had been on my mind before purchasing was a mere groundless fear. At the same time, it's all too handy to be connected to my car all the time. I can adjust the room temperature before I get in the car. Cooling in summer and warming in winter!

(Vocabulary)
combustion 燃えること, 燃焼

四国山地の中央にある町へ手術の応援に来た。術後経過を見るために宿泊し、翌朝外に出ると霜が降りていた。さすがに山の中である。この車を買うときに心配したことの一つにエンジンが無いため車を温める機能が弱いのではないかと言うこと。朝、外に出てみて車を見てびっくりしたが、室内に戻り、出発前３０分くらいにデフロスタのスイッチをオン。出かけるときには霜は消えていた。杞憂だった。車とネットを通じて常に繋がっているのは実に便利な機能だと思う。