From “shikata ga nai” treatment to the “best” treatment
–The new Keiro-Providence Iyashi Care program-Holding HandsAs the medical field advances and comes up with new treatments, many people live longer. In some ways, the innovation is great, but at the same time this means that more people are living while coping with an illness. In some cases, these people may not be able to return to the lifestyle they used to live before being diagnosed with the illness. Now is truly a time in which many people “live together” with an illness.But looking around, I hear many people who receive advanced medical treatment saying, “I didn’t want to go through that specific treatment, but I ended up accepting it, not realizing what I was getting myself into, and now I’m in pain, and don’t know what to do.”Patients have a variety of options to choose from today, thanks to advancements in medical treatment. However, these patients are often in pain and carry fears and anxieties about the future. In mental and health conditions such as these, it may be difficult for the patient to clearly understand the situation while selecting what’s best for them. Doctors are supposed to discuss and decide on the treatment with patients, but commonly, patients are overwhelmed with information and options, and is forced to choose without properly being educated about their illness and options.The Japanese phrase, “shikata ga nai” can be translated to “it can’t be helped.” It is not uncommon to see many Japanese or Japanese Americans who end up selecting a treatment they did not want after becoming confused with medical terminology and jargon, but say “shikata ga nai” and just accept their situation as is.

Every person has a different set of values and life priorities. For some, the best treatment is to control the pain, and to end their life at home. For another, the best treatment could mean receiving any treatment possible to continue living until their children become independent. Additionally, doctors may be limited by time constraints in their capacity to thoroughly discuss these topics with the patient. And if the patient is in major pain or anxiety, he or she probably cannot even think about how they want to live their lives

Yuichi Edwin Yanami MD

I was working in Japan for nearly 10 years doing hospice care until returning to the United States. Working there, I always thought about how to best serve and support patients who are on their final chapter in life, so they can live their remaining life to its fullest.

However, hospice care is only available to those who are close to the end of their lives. Those patients who have just been diagnosed with a serious illness, or those who are receiving treatment now, have many pains, fatigue, and emotional distress, as they struggle to figure out what they want to do with their lives.

True palliative care supports and removes any physical, emotional, and social distress that all patients have from the second they are diagnosed with their illness and throughout their battle with the illness.

If the symptoms are controlled, and the patients have a time to deeply consider their “best” treatment after being explained in detail their illness and the results they should expect from each treatment, then I’m sure they will be able to make the right choice for them comfortably.

At this time I would like to present to you the “Iyashi Care” program provided by a partnership between Keiro and Providence. Together, I would like to help each patient to reduce their physical and/or emotional pain and to think about which treatment will be the “best” treatment that will provide “iyashi” or “healing” in order to live the life they wish.

Yuichi Edwin Yanami MD


About the Author

Dr. Yanami is the Associate Medical Director at Providence TrinityCare Hospice & Regional Palliative Care. He is one of the doctors on the team for Iyashi Care. For full profile of Dr. Yanami, click here.