A leading palliative care doctor, who himself is battling stage-4 cancer, continues to pursue his life's work of providing in-home support to terminally ill patients to allow them to live their final days with dignity.
Fumio Yamazaki, 75, started his career as a doctor at a hospital in the 1970s and witnessed first-hand the suffering and despair of people dying of cancer in hospital wards.
As it was considered taboo in Japan at the time to inform cancer patients of their true diagnosis, they were left in the dark and without knowing the nature of their condition.
Although doctors knew there was no hope of recovery, they often performed excessive resuscitation techniques on their patients, such as artificial respiration and cardiac massage.
In his bestseller, "Byoin de Shinu to Iukoto" ("Dying in a Hospital"), published in 1990, Yamazaki questioned the medical practice in which patients at Japanese hospitals, who deserve the utmost respect as death approached, are instead alienated and given neither treatment options nor decision-making power.
In pursuing ideal end-of-life medical care, Yamazaki became involved in palliative care and has been at the bedsides of more than 2,500 people in their homes or elsewhere at the time of their death.
Yamazaki was diagnosed with colorectal cancer in the summer of 2018. Metastasizing to both lungs the following year in May, it became stage-4. Since surgery and radiotherapy were not viable options, he was advised to receive anticancer drugs.
But he feared that he would have to discontinue his palliative care work due to the strong side effects of the drugs. He said he was unwilling to end his work and give up what he cared about most.
"Up until recently, I had treated many patients and listened to their traumatic experiences. I could empathize with them but I couldn't share in their experience," he said, explaining that now that he is also sick, he has a new perspective.
People with stage-4 cancer can continue their normal lives for a period. Although palliative care may become necessary to alleviate pain in the future, Yamazaki wondered if it was possible to maintain his current condition as long as possible.
He read related books and tried alternative treatment methods based on certain theories, such as diet and drug combinations, to suppress the growth of the cancer.
Although a causal relationship has not been proven, the metastasis has shrunk, now four years since his stage-4 diagnosis. On weekdays, he works at a hospital in Tokyo and a clinic he used to operate for home-visiting medical care.
Being a cancer sufferer himself, he now has a more serious outlook on death. He says the essence of palliative care is "helping terminal patients live the rest of their days in a way that affirms who they are and what they are going through."
The style he is accustomed to as a physician remains unchanged.
He goes to patients' homes alone, dressed in casual clothes, behind the wheel of his car and unaccompanied by a nurse. He tells his patients about his own battle with cancer, leading to sincere and honest conversations.
With the reality of his own death looming, Yamazaki said, "I want my patients to live with dignity until the end."
On this day, the patient asked, "Doc, didn't you promise to be at my bedside when I die?" "That is my plan...I probably can do it," Yamazaki replied.