Dr. Koichi Ito, 52, is an endocrine surgeon and the best-known and most sought-after Japanese authority on the management of thyroid diseases. He is also the third-generation owner of Ito Hospital, ranked as Japan's most progressive thyroid-care medical center. Physicians all over Japan refer their patients to Ito Hospital in Tokyo's Omotesando for its world-class care. In 2009, out of the 277,471 outpatients, 10,000 were referrals. The workload here is heavy: On an average day, the 20 physicians and 18 nurses on duty might see 1,000 to 1,400 outpatients. Yet a visit to Ito Hospital is not a painful experience. While the staff work with lightning speed, supported by an efficient computer system, they are renowned for their kindness, and surely much of this must be down to three generations of the Ito family's humane attitude toward patients.
It's therapeutic to keep the memory of our loved ones alive. One of our colleagues, Dr. Takashi Mimura passed away one year ago, at age 77. We made his desk into a little shrine. We put all the things he loved on it — beer, cigarettes, his favorite sweets — and lots of photos of us with him. No other person will use that desk. He is with us forever. His desk is near the entrance so we say hello and goodbye to him every day. It's like he's still with us, but he's off that day.
Once people are traumatized, the psychological scars might heal but certain issues will remain sensitive. Radiation therapy is very strictly regulated in Japan because of our tragic history, being the only nation to suffer from two separate atomic bombings. In Japan, the government limits the maximum dose of radioiodine (iodine-131) — the substance we use to treat cancer patients — to 500 MBq per person per day, while most countries allow 1,110 MBq for standard therapy. Also, we must hospitalize patients undergoing iodine-131 treatment, while abroad, outpatient care is possible. The idea that a patient undergoing therapy might emit harmful gamma rays and affect others is still extremely strong in the minds of Japanese. The rules, however, severely limit the number of patients we can help and the speed of the procedure. We've lobbied for change, but so far it's been in vain.