Every Human Intention by Dreux Richard

Author:Dreux Richard [Richard, Dreux]
Language: eng
Format: epub
Published: 2021-02-23T00:00:00+00:00

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After eleven years running it, Takagi Tomoyuki, director of Wakkanai City Hospital, retired into the lesser responsibility of managing the city’s geriatric care facility. He kept his office at the hospital. When I visited him there, he was not familiar with the American idiom I’d rather be fishing, but had hung portraits of himself holding a variety of wildlife you get that way. “I’d rather,” he said, adopting the idiom’s structure, if not its spirit, “you were a surgeon.” The hospital had fewer than it needed. He knew because he’d spent a decade addressing the problems imposed on Soya’s health-care system by a severe shortage of physicians.

Few Japanese doctors are willing to move their families to far-flung or second-class cities; the willing promptly exhaust their opportunities for professional advancement, ease their consciences with the time they’ve put in, and return to Tokyo. To the extent that someone like Takagi would “pay what it takes” out of the discretionary parts of his hospital’s budget, that hardly matters. The recruitment of doctors is an elaborate process, founded on professional prestige and institutional relationships. Rural hospitals can’t compete.

“The shortage of physicians gets worse,” he said. “The doctors who staff the clinics retire. The hospital struggles to attract specialists. See what I’m implying? Hospitals become clinics. People are becoming accustomed to the idea that a hospital—what you or I think of as a hospital—is an urban amenity. People who are less educated, less wealthy, people with fewer resources, they take what they can get where they live, which puts hospitals in the business of providing care that obscures the human consequences of a region’s decline.”

Before settling in Wakkanai, Takagi was a military physician, and for a time he was assigned to Antarctica. Now he was a reverse commuter, visiting Sapporo twice a month to see his family, who had not volunteered to remain in a city where trains depart without anyone aboard and movies screen to empty theaters. He still gave an impression of military discipline. His carefully groomed mustache suited the severity of his speech, and in his office the clutter was arranged—without exception—at right angles. His dignity, I knew from the other Antarctic explorers who lived in Wakkanai, made him a preternatural victim of humorous accidents, and it was easy to picture a gust of wind destroying the meticulous order in his office, to imagine the blur of frantic gestures he would make to hold everything in its place.

When I met Takagi, he asked if I’d gone people watching at Wakkanai Airport when the nonstop from Tokyo arrived. The flight was prohibitively expensive, but seniors could book it with a subsidy. “You’ll notice the lightness of souls,” he said, “and the process that dissolves them.” The next week, I watched the arrivals lobby fill with unaccompanied elderly passengers. Before they reunited with the friends and families who came to meet them, an interval of quiet passed through the lobby. The elderly went to Tokyo for medical procedures. In the airport, their loved ones waited to see how they would disembark—healed or unchanged.

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