Shigeaki HinoharaBMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3891 (Published 22 August 2017) Cite this as: BMJ 2017;358:j3891
Shigeaki Hinohara was a friendly man with a childlike zest for life. He was vibrant and hardworking—when he turned 100 in 2011 he was still practising medicine, writing books, and giving inspirational talks and speeches. Perhaps Japan’s most famous doctor, he was loved by millions and was considered a national treasure.
Hinohara began his medical career in 1941 in Tokyo at St Luke’s International Hospital, founded in 1902 by a missionary doctor. A devout Christian, Hinohara remained at the hospital for the rest of his life. He was named chief of internal medicine in 1951 and hospital director in 1992. At the time of his death he was honorary president of the hospital and chairman emeritus of the board of trustees of St Luke’s International University (previously St Luke’s College of Nursing).
Discovering William Osler
Hinohara fell under the spell of legendary Canadian physician and humanist William Osler in August 1945 when, shortly after the end of the second world war, US Army chief surgeon Warner Bowers gave him a gift ofOsler’s book Aequanimitas: With Other Addresses to Medical Students, Nurses, and Practitioners of Medicine. The book became Hinohara’s “companion on the journey.” In 1983 he cofounded the Japan Osler Society and was an honorary member of the Osler Club of London and the American Osler Society.
In 1983 he and Shakespeare scholar Hisae Niki published a book of 20 of Osler’s lectures translated into Japanese. In 2001 they published an expanded annotated version in the original English, under the title Osler’s “A Way of Life” and Other Addresses, with Commentary and Annotations. In the book’s foreword, John P McGovern, the renowned allergist and cofounder of the American Osler Society, describes the work as an “invaluable resource” and Hinohara as “a great Oslerian who has spread Osler’s principles and ideals throughout the world.”
Innovator and writer
Over the years, Hinohara made numerous contributions to improving medical care in Japan. These included pioneering comprehensive medical check-ups and advocating patient-first medical care in the 1950s. Under his guidance St Luke’s established Japan’s first department of palliative care medicine, the first department of psychosocial medicine, and the first residency training programme for young doctors.
At the age of 75 Hinohara began a prolific writing career. He was the author of nearly 150 books on a wide range of health, cultural, self help, and societal topics. His 2001 book, Living Long, Living Good, with advice on staying healthy and happy in old age, was a bestseller and stemmed from his advocacy for what he called the “new elderly.”
He argued that the global definition of old age beginning at 65 was no longer valid. He decreed that the new threshold would be 75, and in 2000 he founded the Association for the New Elderly. He encouraged older people to remain active, keep learning, seek new challenges, and, as he put it, simply have fun like you did as a child.
Hinohara practised what he preached. In New York City in 2010 he attended the US premiere of the Japanese musical Freddie the Leaf, which he conceived based on the book by Leo Buscaglia. At the time 98 years old, Hinohara joined the child actors on stage for the grand finale, enthusiastically swaying to the music.
Karsten Thormaehlen, a German photographer known for his portraits of centenarians, photographed Hinohara in Tokyo in 2013. “He was a very elegant, generous, eloquent, and wise man,” Thormaehlen told The BMJ, adding: “I had the impression I was talking to a much younger person.”
Life and career
Hinohara was born on 4 October 1911 in Yamaguchi Prefecture in western Japan. His father, a Methodist pastor, had studied at Duke University in North Carolina. Hinohara started studying medicine at Kyoto University, but in his second year he contracted tuberculosis. He was bedridden for eight months, an unpleasant experience that he later said enabled him to empathise more with patients and be a better doctor.
After recovering, Hinohara resumed medical studies, graduating in 1937. He trained for two years at Kyoto and then did doctoral work in cardiology, receiving a PhD for his study on atrial heart sounds detected through the oesophagus by means of a tiny microphone that he devised.
In 1941 he joined St Luke’s in Tokyo, where he remained during the second world war. In 1943 he married his wife of nearly 70 years, Shizuko. They would become parents of three sons and grandparents of six. In March 1945 Hinohara treated victims of the firebombing of Tokyo, considered the deadliest and most destructive in history. Later in life he became an outspoken peace advocate and spoke regularly to children at schools across Japan about the beauty of life.
“The pacifist movement in postwar Japan failed to achieve peace,” he said in a 2006 interview,1 adding: “What I’m trying to do these days is to tell 10 year old kids to love the plants, the trees, the animals, and other people. It is one of my dreams to teach children about the importance of life.”
In the early 1950s Hinohara spent a year in the US at Emory University in Atlanta for advanced studies in general internal medicine under Paul Beeson. On his return to Japan, he focused on cardiology, psychosomatic medicine, water and electrolyte metabolism, and preventive medicine.
“A new life”
In 1970 he was on a domestic flight that was hijacked by Japanese Red Army members and ended up landing in South Korea. Hinohara and his fellow passengers were handcuffed and spent a “scary” three days and nights in the plane before being released. “I was nearly 60 then,” Hinohara later said, “and I felt that my life had ended once, and that I was given a new life—a life that I was determined to devote to selfless love for the social good.”1
In 2005 Hinohara was awarded the Order of Culture, Japan’s top honour. Over the years he served on several government committees and was active in medical associations. His international memberships included the American College of Cardiology, and he served as president of the International Society of Medicine.
During the 1990s his focus turned to ageing, hospice care, and alternative approaches to healing, including music therapy. A newspaper article in 2009 noted Hinohara’s legendary “magic touch” as a doctor and outlined some of his thoughts on medical care, which included: “Science alone can’t cure or help people. Science lumps us all together, but illness is individual. Each person is unique, and diseases are connected to their hearts.”2
Psychiatrist Rika Kayama earlier this year wrote a newspaper article3 about the time she accompanied Hinohara on hospital rounds of a ward of cancer patients who had decided to stop treatment, preferring palliative care. “One of the patients,” Kayama recalled, “fought back tears as she said, ‘I am also Christian, just like you doctor,’ which prompted Hinohara to reply, ‘Is that right? In that case, let’s break with conventional treatment and pray.’ The doctor then took hold of the patient’s hands and started to pray. After which, the woman’s expression became much calmer in no time at all.”3
Shigeaki Hinohara (b 1911; q Kyoto University, Japan, 1937), died from respiratory failure on 18 July 2017