Dear my future doctors Dear my patients

thank you

i am a cardiologist doctor taking care

of heart disease

twenty years ago i was

a masked writer

do you know the masked writer

the masked writer is a legendary

japanese hero

like spiderman or superman so to speak

am i kidding you no i’m serious

i have a son on the daughter

when they were little we used to play

together playing soccer

basketball football at the playgrounds

playing chess at home reading books

lovely

but at the same time i was a busy

cardiologist i was on call

i was on duty 24 hours seven days

every day no skips no thanksgivings

no christmas holidays no new year’s

holidays

i was often called from a hospital

hello dr camro we need you right now

we have a patient with a heart attack

he’s in shock

i gotta go i talked to my children

they repried come on dad why

are you leaving us alone actually they

cried

i felt terribly sorry for them

i felt guilty and talk to them

listen honey this is top secret

i never told you before

i am a masquerader

i gotta go see people from monsters

then the sad face is suddenly turned

into golden smile

hey dad are you sure are you a mass

brother

wonderful we’re proud of you go be the

monsters

since that day i became

a hero for my children

you will derive immense joy and

satisfaction

in helping others in the moment of

crisis

it is indeed rewarding

but the same time you will also

appreciate

the costs of this profession sacrifices

you make

that is altruism

giving others without regard to yourself

the mask rather is a perfect example

of altruism he battles evils

and risks his life not for payment

but because it’s just the right thing to

when i was a mask writer i felt exactly

the same

one other thing mask writer and i did

was we were both paid

zero nevertheless i was simply happy to

help people

and help my junior doctors

nowadays however the mask rider

in the field of medicine is under threat

the bigger threat is medical litigation

this slide shows the changes in the

number of legal actions

against physicians in japan

i stood my career in 1994

so i grew up in this

upward trend

i just remember my residency my senior

doctor used to tell me

a kill even if you make mistakes

don’t apologize to your patients never

say

i’m sorry

i just didn’t get what he’s saying

so i asked him sir uh may ask uh

what you mean he said

a q if you say i’m sorry

that means you admit your mistakes

and that means you will lose

in a lawsuit

in 2006 a japanese obstetrician was

arrested by the police

for criminal negligence

did he commit a crime no

he tried hard to save a mother and a

baby

but the mother died the mother

could have been saved in a bigger

hospital with

hundreds doctors but unfortunately

the incident happened in a rural

hospital where

the doctor was only of situation

talking about myself i have never been

sued

but i’ve been simply lucky

because i had so many close calls

now doctors face a substantial risk

of being sued according to recent

paul 10 of japanese doctors

have experience of malpractice

litigation i don’t mean to warn you

my young fellows if you look at the

united states

24 of surgeons are sued

in their career and they’re paying 30

000 for malpractice

insurance if you live

in a fear of being sued

you can’t really be a master rider

dr references and the colleagues have

done excellent

researches on this they recorded

conversation between patients and 124

doctors and try to find

specific communication behaviors

associated with

malpractice litigation

and they found striking differences

between

doctors who had been sued and who had

never

doctors who had never been sued they

were

more likely to be sociable

and have gentle torns in their voices

and spend longer time with the patients

but the difference is only three minutes

three minutes longer

i am doing operations called cardiac

catheterization

sometimes they’re risky and challenging

and sometimes

they are not perfect

interesting when my patients went home

they often told me dr gomura thank you

very much

for everything you did perfect job

even though my operation was not perfect

i failed

on the other hand when i felt my

operation was perfect

unexpectedly they complain

why does this happen

when i felt my operation was not perfect

i went to see my patients often and did

my best effort

to foster good relationship with them

but when i felt i did

splendid job probably i didn’t much

i didn’t pay much attention to my

patients and i

slept off so

if you have good relationship with your

patients

they are unlikely to complain they are

unlikely to sue you but if you have

no relationship they will be less

forgiving

when i was working in a university

hospital 10 years ago

i had 60 patients for 4 hours

crazy i could spend

just a couple minutes for each patient

my patients

were not happy i wasn’t happy either

i was exhausted

i couldn’t stand anymore i almost

burned out

as time went by i nearly lost

the happiness and the satisfaction which

comes

with this profession

i have an old friend he’s an american

he’s in 60s 12 years ago

he was brought to the hospital by ambers

he had a heart attack

i fixed his artery immediately and he

made the phenomenal recovery from the

edge of the death

but i just did what i got to do

recently he sent me an email

i’m surprised he still believes i am his

mask rider

our profession is special

patients are willing to disclose us

the secret personal information

they’re willing to get unrest in front

of us

they let us perform dangerous procedures

which could possibly do harm by trusting

they save their lives

they make our profession special

by saying thank you doctors and it is my

patients who make it possible for me

to be a mask rider

now what can we do

to make the doctor patient relationship

better and special

i believe there’s three things which are

important

number one communication

when i was a cardiology fellow in

beautiful town massachusetts united

states

i used to see patients in outpatient

clinic

i could spend as long as 30 minutes or

more for each patient

it’s really fun talking with them we

talked over

the family where they lived the boston

red sox came the day before

the story when my patient was a u.s

marine in okinawa

it’s fun and we were able to become

friends

easily

and second the tone of your voice

and the smile on your face if your

patients find you

comfortable nice and gentle

they will get much happier

young doctors

our job is not simply

to save people because

we cannot save every people

our goal our ultimate goal is to make

them

happy so

please be nice and gentle

if i could go back to my medical school

days

i would have applied for a part-time job

in a male host club

host club

yeah i’m serious

in my age i have no chance of being

hired as a male

host but you can do it

i believe it might have given me

the opportunity to learn about people to

learn

how i can be nice and gentle

right so please

and finally be sincere be honest

if you make mistakes apologize

don’t hide don’t escape

if you hide something your patients will

not forgive you

my senior doctors in my residency what

they told me was totally

wrong

my young doctors my future young doctors

please learn about people

love your friends people around you

i don’t believe medical school

curriculum

is the best format to learn all about

these

all about people okay

you’re still young there’s many things

which can be only

achievable while you are young

so try everything get out of the grass

down something outside of medical

science

and dear my patients give my friends

dear people

all around the world please know this

we doctors are not hundred percent

we cannot save everybody

but we promise that we do our best to

take away from the pain

and anxiety we promise that we do best

to make you feel better make you feel

happier please remember

the life is not eternal

so let’s enjoy our life as much as

possible

we will be we doctors will be

your lifetime pertainers and

once in a while we will become

your mask writers thank you very much

for attention

you