Asahi Shimbun Morning Edition – September 4, 1999
A middle-aged man who had traveled nationwide as a peddler to support his family developed a stomach ulcer. He suffered massive hematemesis (vomiting blood) and was rushed to the hospital. An endoscopy confirmed bleeding from the ulcer site, and he received a large blood transfusion before undergoing surgery to remove three-quarters of his stomach.
He returned to work but became easily fatigued and lost his perseverance. When he visited an internal medicine doctor, he was diagnosed with post-transfusion hepatitis C.
He became irritable and depressed. He felt an overwhelming sense of helplessness, as if he were disappearing, and tears welled up in his eyes for no apparent reason. His sleep was shallow, plagued by unpleasant dreams. He feared he might soon die of cancer and became anxious even at the sight of a kitchen knife. His appetite diminished, and he lost 10 kilograms in three months.
Fortunately, the hepatitis C virus was successfully eradicated with interferon therapy, an immune-boosting treatment. However, he was later diagnosed with depression by a psychiatrist. His condition worsened even after hospitalization, and he could no longer continue peddling.
The Japanese film Kanzo Sensei, released last year, is, in my opinion, a masterpiece among medical-themed domestic films, on par with Red Beard and The White Tower. It was directed by Shohei Imamura and based on the original work Kanzo Sensei by Ango Sakaguchi.
The story is set in Tamano City, Okayama Prefecture. The protagonist, played by Akira Emoto, is a doctor who believes that “a general practitioner is defined by his mobility.” Carrying his medical bag, he rushes through the Seto Inland Sea region in the final days of World War II. Due to poor nutrition and lack of rest, many patients he sees can be diagnosed with liver disease at a glance.
He is an energetic doctor who petitions the military for the distribution of expensive intravenous drips and strives to identify the causes of the disease. At a meeting of his medical school alumni, he presents findings based on 1,500 medical records, earning high praise for his achievements and passion. However, amid the war, the military is reluctant to acknowledge the widespread outbreak.
Currently, an estimated 2.3 million people in Japan suffer from hepatitis C. It has become clear that hepatitis is not only caused by alcohol but also by several types of viruses. Treatments aim to prevent the progression to cirrhosis or liver cancer, but immune-boosting drugs can also affect the brain and mood.
Although modern-day Kanzo Sensei doctors do not make house calls on foot, they are now employing molecular genetics and strengthening collaboration with psychiatrists.
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