FUKUSHIMA Lives on the Line

chap.IVPatient Relief Activity Records [Essays and Research Publications]FUKUSHIMA: Lives on the Line201fear and ignorance. Various countries have imposed blanket bans on all agricultural imports from Fukushima and surrounding prefectures. Domestic sales have also been affected, as retailers anticipate what is, and is not, likely to sell.A favorite walking path between home and hospital goes past many rice fields. It keeps me in touch with the seasonal nature of farming, and the hard work that goes into the brown rice and natto soybeans that comprise my usual breakfast. Those who are condemning this delicious Fukushima rice don’t seem to know that the harvest was last fall, months before our earthquake, tsunami, and nuclear reactor troubles. Let’s not condemn ignorance, but let’s deal with it.People along the coast have lost their homes and livelihoods. People near the crippled nuclear reactors have been evacuated, and various crops, nurtured at great expense and care, will not find their way to market or to palate. A kilometer from my home, and many kilometers away from any tainted produce, a farmers’ market convenes on Saturday mornings, spring through fall, around one tiny building in a lush setting of rice and vegetable fields. This year’s start date for Nakazawa Chokubai was meant to be Saturday, March 19, but, as posted, activities will be suspended until matters relating to the nuclear accident and radioactivity are resolved.April 2, 2011International media attention and domestic anxiety seem to focus on nuclear power plant issues, and possible long-term effects of stray radioactivity. Caregivers have to consider an even bigger picture. Our hospital is once again receiving non-urgent patients, but FMU teams continue to travel around the prefecture, attending to refugees.One team specializes in psychological issues related to loss of loved ones, loss of livelihood, loss of home, and all the uncertainties related to radiation exposure. That team leader will one day have a good narrative for the rest of us, but in the meantime, regrets that demands on his time have stood in the way of reporting to the international community.Another team’s focus surprised me, although I should have known. “Economy class syndrome” is a popular name for deep venous thrombosis (DVT), owing to its occurrence in airplane passengers who are immobilized for long periods, and often dehydrated. DVT is prevalent among our disaster refugees. Consider the situation: lack of potable water in the early stages of evacuation, and self-imposed fluid restriction when water becomes available but toilet facilities are inadequate. Emergency accommodations on gymnasium floors and the like are orderly in Japan, but crowded in a way that may inhibit movement. Lack of food translates to lack of energy, and even after caloric needs have been addressed, some shelters stand in the midst of rubble. Where refugees can step outside, anxiety about airborne or rain-borne radioactivity may discourage excursions.Economy class syndrome is serious; it can be deadly when a deep vein thrombus dislodges and becomes an embolus. Economy class flying attracts grumbles, but even across oceans it is measured in hours, not weeks, and – with rare exceptions – passengers know where they are going.April 6, 2011This week, a surprising offer of aid from Nebraska brought to mind a natural hazard common in the American Midwest: tornadoes. This is the start of Nebraska’s tornado season, but our friends and colleagues said nothing of this; they were preoccupied with post-earthquake conditions in Japan, and eager to help. South of Nebraska is Kansas, where, famously, a tornado brought Dorothy to the Land of Oz. The principal casualties were two malevolent sisters. After an adventure with new friends, Dorothy found her way back to Kansas, where relieved family members heard her say, “There’s no place like home.” Tornadoes, like earthquakes and tsunamis, take innocent lives, and deprive survivors of places called home.Professional meteorologists, and amateur storm spotters, are indebted to Kyushu-born Professor Tetsuya Fujita (1920-1998) for, among other things, developing the F-scale to correlate a tornado’s intensity with its impact on structures and vegetation. An F0 tornado is the mildest; an F5 is the worst.An F5 tornado that devastated Rochester, Minnesota in 1883 inspired Franciscan nuns to support the medical relief work of two benevolent brothers, and ultimately, build a hospital. Countless patients, and more than 20,000 trainees, are among the beneficiaries of that humble beginning. Tornadoes, floods, and other disasters continue to influence medical education at the Mayo Clinic. At the