Will of Dr. Nagataki
Sanae Midorikawa
Professor, Miyagi Gakuin Women's Univerisity
I first met the late Dr. Shigenobu Nagataki, a well-known expert in thyroidology and the health effects of radiation, at an international conference three years after the Fukushima nuclear accident. Dr. Akira Ohtsuru, who was once a graduate student and a medical staff of Dr. Nagataki, introduced me as a chief doctor on the thyroid examination scene. At that time, the first round of thyroid examination had been completed, and the second round was undergoing. The number of thyroid cancer in children was increasing rapidly. Many Fukushima residents renewed their anxiety that the health effects of radiation might have occurred to them. Dr. Nagataki, an expert on both radiation and the thyroid, assured me that it was unlikely to be the effect of radiation. So I could explain it to the residents with confidence. After then, I had few opportunities to talk directly with him. However, from time to time, he emailed Dr. Ohtsuru. He let us know about some critical academic papers and his interpretation of the data. Furthermore, he sent us and let us read his book, “Health Effects of Radiation Learned from Nuclear Disasters and Countermeasures,” which was published very early after the nuclear accident (January 2012).I would like to introduce some descriptions from Chapter 8 in this book, ’The protection, relief and assistance of the exposed people’ as below. "Unregulated health examinations only increase the psychological distress of the survivors. Even when the survivors are free to take general medical check-ups, they are still worried because every time they find an abnormality, they regard it as the consequence of radiation exposure. Before starting a health survey, we should examine past disaster cases (including not only nuclear disasters but also other natural disasters). We should plan carefully so that we can clarify the purpose of the survey and the survey contributes to the true welfare of the people." He wrote about the health survey on the Fukushima nuclear accident as follows. "It might be recommended to carry out a health examination in consideration of psychological aspects. However, based on the experience of disaster cases so far, the survey should be carefully planned so as not to promote further anxiety." I read it again and was impressed by the fact that Dr. Nagataki foresaw the survey's negative effect, even before the thyroid examination was started.
In September 2016, two months before Dr. Nagataki died, the 5th Fukushima International Expert Meeting on Thyroid Cancer after the Nuclear Accident was held in Fukushima. Dr. Nagataki gave a keynote speech entitled "Nagasaki University: 30 Years after the Chernobyl Accident: Contribution from Japan". He talked about his involvement as a thyroid expert after the Chernobyl accident and cooperation with international organizations such as the IAEA and WHO.
In this meeting, Dr. Ohtsuru gave an overview of the results of the thyroid examination, and as a member of Fukushima Medical University, reported that overdiagnosis had occurred, for the first time at an international conference. Also, I presented some problems in the thyroid testing: 1) The results of the test was causing new anxiety, 2) false-positive results and overdiagnosis were occurring as disadvantages of the thyroid cancer screening, leading to psycho-social problems, and 3) the survey was carried out in a semi-enforced manner (Slides for the presentation).
At that time, Dr. Nagataki was a little inconvenient to walk due to his condition. When my presentation was over, and I got off the podium, he, who was sitting in the front row, bothered to stand up with the support of his wife and spoke to me. He praised me that he was much impressed by my presentation. Furthermore, in the general discussion the next day, he made a statement that the thyroid test should be stopped to continue in a present manner if it had been started only to deal with anxiety. When I met him again at the Japanese Thyroid Society a few days before he died, I had some time to talk with him. He said after listening to my presentation, he realized that the scientific facts do not directly lead to the peace of mind of the residents, and he hoped he would make an effort to modify the survey so that it would genuinely benefit the Fukushima residents and give them confidence.
I have always cherished these words and take them as the will of Prof Nagataki. Dr. Nagataki was the leading expert in the contribution at Chernobyl and might have been one of the heroes in Chernobyl in a sense. However, he understood the truth about Chernobyl and the pain of the residents. He did not become a hero in Fukushima. I believe he was always thinking about what was necessary for the Fukushima residents.
Since he had a strong influence on the government, I think that if Dr. Nagataki were still alive, the thyroid examination would not be like as it is now. I would like to consider again what we should do to meet the expectations of Dr. Nagataki.