だれもの命の原点は子宮であり、触れること、触れあうことの大切さを伝えたい（2012.2 All about)
Dynamic Obstetrician Takeuchi Masato
‘Infant Death’ taught me what I had been searching for as an obstetrician
By a process of elimination, the path to obstetrics
Takeuchi graduated as a medical professional in the late 1980s. At the time the baby-boom had ended and Japan moved into a period of falling birth rates. As a medical practitioner the most attractive option was surgical medicine, obstetrics and gynecology was said to be in decline. Takeuchi, however, chose the path of obstetrics.
“I too felt an attraction towards surgery. But from long ago the part of my personality that cried out ‘I want to do something different from other people’ would not let me rest. I also thought about pediatrics, but when it came to becoming a doctor, I felt I wanted to be the one holding the scalpel, and in the end, from the choices I had left I decided on obstetrics as the field that I had felt a real resonance with during clinical practice.”
By a process of elimination, obstetrics and gynecology had been chosen. Prospects for the future were hazy, and salary conditions among other things were put well in the shade when compared to other areas of medicine. But, it was surely enough to make a living.
Giving back to society, or so I believed…
After completing medical training at the university hospital, a period of being dispatched to a regional hospital followed, then time doing research until working as a head obstetrician at a perinatal center in Tokyo. By providing safe deliveries he believed he was contributing to society, and with this belief, between sleeping, he gave his all to his work. At the time new technology was being introduced to the field, and if the rate of treatment development continued at this pace, there was even an illusion that obstetrics would be able to save every single mother and child.
However, even then, it was not the case that every life met with a fortunate outcome. “At the time, for me, medicine was a job which required calmly dealing with patients and, whatever happened, going into battle against it completely encased in a cool attitude of steely professionalism. A life that could not be saved was beyond the scope and range of treatment. And so, my approach toward a baby was probably that if in the range of being saved, it was a ‘person’, but if beyond that, it was more like a ‘thing’.”
The ‘Infant Death’ that changed his identity as a doctor
Having worked in obstetrics for ten years he discovered that a baby he had desperately fought to save had later been subjected to abuse from the parents, and that the family had broken up. “I believed that they should all be happy by now… Could it be that perhaps I had caused the family to disintegrate by forcibly trying to help, and that this child had suffered from it. If so, then, I had to think more about what was happening to the mothers and babies I had helped up until then.”
“To save the mother and child,” was all that Takeuchi had been able to see, but compelled to doubt and wonder what it was that he had been doing up until now, he fell into an identity crisis as an obstetrician.
And so for the second time he would be forced to face up to the death of a baby, and this would change his whole approach as an obstetrician. In a case where, due to the early detachment of the placenta, he performed an emergency caesarian section, the baby could not be saved. It must have suffered through the experience, and yet the baby’s expression was very calm and peaceful. Initially, in line with standard practice in Japan, thinking it would be “too difficult to ever forget,” he resisted passing the deceased baby to the mother, but this time he somehow wanted to let the two be together… In an instant Takeuchi wrapped the baby in a warm white towel and softly handed the bundle to her, just as he would have done with a healthy living baby. An hour later, the mother who had been stricken with panic had now changed to a calmer composer.
After leaving the university hospital, the Grief Care Specialist Clinic and life counseling
The death of this baby sparked the emergence from a long tunnel for Takeuchi. “Even if the baby cannot be saved, for the family, the case does not end there. For any baby there is a reason for being born, and here was a narrative that we obstetricians had left out. Because of this I realized that whatever the circumstances we must be involved with the baby with greater care.”
At the same time, on account of a viewpoint now focused on ‘infant death’, a strong desire to move beyond obstetrics and the medical service community of the hospital, and link the medical profession with society, compelled him to leave the university’s obstetrics and gynecology faculty.
For almost a year he put himself out in the field at the point of care provision, and then with the help of connections he decided to return to obstetrics. On this occasion, for parents who had lost a baby he set up a specialist clinic centered on prenatal and postnatal grief care. Here was a space where one would simply wait for the user to begin to talk, and even silence could be shared. “For my part, I cannot directly heal such pain, anger or sorrow. But this time may provide an opening cue, to begin coming to terms with the unbearable emotions building up deep within.”
This approach was connected to the The all-round life counseling center
Achievements through JICA projects and international adoption work
Takeuchi had been interested in the work of JICA (Japan International Cooperation Agency) since before entering medicine. Beginning with involvement in a mother and child health project in Vietnam, he made visits to Nicaragua, Palestine and Madagascar among many others. “In developing countries, medical professionals are still rather authoritarian, and the treatment of pregnant women often less than adequate. But, once you leave the hospital and go into the regions, the children’s eyes are sparkling, and mothers and their children and families are living life much more vibrantly compared to Japan; they look happy,” recounts Takeuchi. Medics and mothers; activities that strike a focus on a sense of rapport with families and the role and presence of medical practitioners, as well as infant death, have been some themes covered in workshops he came to present. And furthermore, in order to save the lives of babies born from unwanted pregnancies, he engaged in international adoption projects. “Babies abandoned by their real parents can be loved and cherished from the heart by adoptive parents, and what’s more their relatives and friends can rejoice in the bond for them. Whenever I find this I am made to think about the relationships between people and between people and families.”