近畿大学医学部・病院50周年史
Survey or Interview東田 有智

「人は力」
患者の痛みを理解し断らない診療を

“People are Our Strength”
— delivering medical care that truly understands patients’ pain and never turns anyone away.
TOHDA Yuji

Director

First graduating class of Kindai University Faculty of Medicine,
Founding Professor of the Department of Respiratory and Allergy Medicine, Hospital Director
––The ‘eldest son’ of the battling Kindai University Faculty of Medicine

It was by a curious twist of fate that TOHDA Yuji chose Kindai University Faculty of Medicine.
One day, he heard that Kindai University was establishing a medical faculty. The entrance exam site was in Higashi-Osaka City, where the university’s main campus was located.
"It was right near my house," he recalls. "I decided to take the exam as if it were just a practice test. I went in with a light heart, even played pachinko during the lunch break, and then went back to finish the exam."
His first choice had been Nagoya University, where applicants could list multiple preferred faculties. He failed to gain admission to the Faculty of Medicine there but passed for his second choice, the Faculty of Agriculture. Exhausted from the long months of exam study, TOHDA seriously considered abandoning the idea of becoming a doctor and instead pursuing agriculture. His other option was Kindai University Faculty of Medicine, which he had taken on a whim—and passed.
"This place is expensive compared to a national university," he told his parents. They asked, "But do you truly want to go?" "I realized that I did still want to become a doctor. When I said yes, they agreed," TOHDA recalls.
Although the medical school was in Osaka Prefecture, its location in Sayama was unfamiliar to him.
"I never had any reason to go out on the Nankai Line. From my house, I had to go all the way through Namba Station to get there—and coming home was the same. Of course, once you get off at Namba, you never make it straight back home," he says with a laugh, hinting at the temptations of the busy entertainment district.
The inaugural class of the new Kindai University Faculty of Medicine consisted of 110 students. At the time of enrollment, Kindai University Hospital had not yet been completed, and only the new students occupied the Osaka-Sayama campus. Everyone knew each other, and the atmosphere was warm and friendly. The faculty itself was still finding its footing, and in the early days the curriculum was somewhat unsettled. In May of his second year, the new university hospital was finally completed, and with each incoming class the campus gradually took on the air of a true medical school.
TOHDA Yuji had vaguely assumed that he would one day become a surgeon. Then came a turning point. Outgoing and fond of lively company, he usually ate with classmates. But on this particular day, finding himself without a companion, he stepped alone into a small restaurant near the university.
"It was a place like a humble rice-bowl shop. There sat the professor of the Fourth Department of Internal Medicine. He invited me to join him for a drink. Afterward, he even took me back to his home, where we drank more together," TOHDA recalls.
That chance encounter became his introduction to Professor NAKAJIMA Shigenori, a pioneer in respiratory and allergy medicine in Japan.
"Professor NAKAJIMA asked me to join the Fourth Department of Internal Medicine. Out of gratitude for his hospitality that night, it was hard to refuse. But I wanted to do surgery, especially cancer treatment. So, I told him, ‘I won’t do asthma. If you let me work on lung cancer, I’ll join the Fourth Department.’"
In those days, internal medicine departments were identified by numbers and were known as the “numbered departments.” The Fourth Department at Kindai University Faculty of Medicine had been established considerably later than the first three. It had no dedicated ward of its own, so students rotated through other departments’ wards during training. Yet because the department was small, TOHDA was able to gain hands-on experience earlier than most.
Even so, he never lost sight of his original ambition to study cancer. At one point, he even arranged on his own to train at the National Cancer Center. It was not until 1991, eleven years after graduating from medical school, that TOHDA finally decided to make respiratory medicine, and specifically asthma, his life’s work.

The engine really started running in his late thirties.

In August 1991, TOHDA Yuji traveled to the United States to study at the Mayo Clinic, one of the world’s leading medical institutions based in Rochester, Minnesota. There he trained under, Gerald Gleich, a renowned authority in immunology and allergy, whose laboratory attracted students from across the globe.
"The first thing that struck me was the way people thought. These were people with real ambition—some even openly said they wanted to win a Nobel Prize. Compared to them, I was just someone who had come abroad for the experience, almost like going on a trip. It really made me realize I had to take my studies more seriously,” he reflects.
At that time, TOHDA was already in his late thirties. By his own admission, he was a late starter.
"Rather than focusing directly on asthma as a condition, I engaged in basic research on immunology and allergy. And through that, I came to understand just how profoundly complex asthma really is."
Asthma is an allergic inflammation accompanied by paroxysmal shortness of breath. It is triggered by immune reactions to antigens that, under normal circumstances, should be harmless. The causes are wide-ranging—from household dust to pet hairs. What makes it especially troublesome is that such immune reactions occur only in certain individuals.
"At the time, there was still the attitude of, ‘It’s just asthma.’ It was common to hear of children with asthma having to miss school when their symptoms got worse. But in truth, even with asthma, one should be able to live a normal life."
Asthma is one of the so-called common diseases that many people may suffer from. Yet despite being so widespread, its pathology remained far from fully understood. That fact only deepened TOHDA’s conviction: he wanted to help those who were struggling.
After about two years of study in the United States, TOHDA returned to Japan, where he became deeply involved in mentoring his juniors at Kindai University Faculty of Medicine.
"I felt I had a responsibility to help the graduate students earn their degrees. Maybe it’s just my personality, but I felt a responsibility to look after those who came after me. By helping my juniors with their research, I found myself drawn deeper and deeper into the study of asthma."
As a member of the very first graduating class of Kindai University Faculty of Medicine, TOHDA Yuji carried with him a strong sense of responsibility as one of the school’s “eldest sons.”
In 2002, he established the Department of Respiratory and Allergy Medicine, becoming its inaugural professor. Over the years, he went on to hold key positions both at the faculty and at the hospital, and in 2016 he was appointed Director of Kindai University Hospital.
“When I first entered medical school, I never imagined I would stay on at the university, let alone become hospital director. At the time, I thought that if I could just gain experience and eventually open my own private practice, that would be enough,” he says with a laugh.
What ultimately pushed him forward, however, was that same feeling of obligation as an “eldest son.” At the time, the financial condition of Kindai University Hospital was far from healthy, and someone had to take responsibility for setting it right.

Unless there are many graduates of the Kindai University Faculty of Medicine, the ‘university’ and the ‘hospital’ will not improve.

After assuming the role of hospital director, TOHDA Yuji set out two guiding principles. The first was to accept every patient who came to the hospital.
“At the time, patients were being turned away on the grounds that there wasn’t enough capacity. But people naturally tend to take the easier path. So, whenever a patient was refused, I required the staff to submit a reason. If I wasn’t convinced, I spoke directly with the person responsible. Gradually, it became the norm to accept patients rather than turn them away.”
The second principle was cost reduction, for which he enlisted the expertise of external specialists. At the same time, he also strengthened collaboration with nearby hospitals. The term of office for hospital director was two years, and by his second term, the hospital’s finances had turned into the black.
Just as stability returned, however, an unprecedented challenge arose: COVID-19.
“When I first heard the initial reports, I had no idea how powerful the virus was or exactly what we were up against. But I immediately sensed it would be serious.”
Severe cases required isolation in negative-pressure rooms to prevent leakage of the pathogen, and sometimes treatment with ECMO (extracorporeal membrane oxygenation) was necessary. Only a limited number of institutions were equipped to provide such care. At a meeting of the directors of the five university hospitals in Osaka Prefecture, TOHDA proposed that “university hospitals must take in the severe cases,” and the group reached a consensus. At Kindai University Hospital, emergency services were continued without interruption by relocating part of the emergency department and dedicating a ward to COVID-19 patients.
At that time, it was not even known whether the virus spread through airborne transmission, and medical staff naturally felt anxious for their own safety. To address this, TOHDA gathered the doctors and nurses working on the front lines and told them:
“Our emergency department is the safety net for Minamikawachi. If we shut it down, people will die—lives that could have been saved will be lost. Emergency medicine must continue as usual, while COVID-19 will be handled by the Department of Respiratory Medicine.”
It was, he emphasized, something that someone had to do. At the same time, he authorized the purchase of necessary equipment. He instructed staff to contact him directly should anything occur, keeping his cell phone by his pillow even while he slept. Whenever time allowed, he personally visited the frontline.
When the news spread that Kindai University Hospital was treating COVID-19 patients, donations of supplies began to pour in—many addressed personally to TOHDA Yuji. He recalls feeling heartened, realizing that everyone was standing behind them in support. Remarkably, not a single staff member left the hospital because of COVID-19.
“People are the true strength,” TOHDA affirms.
When asked what kind of students he hopes will come to Kindai University Faculty of Medicine in the future, TOHDA replies quietly, “Well, people who dislike people probably aren’t suited or this profession.”
“A doctor is paid to provide treatment, and then the patient says, ‘Thank you.’ There’s no other job like it. Patients come to us because something is wrong, because they are in an abnormal state. Even the sound of slippers on the floor can be irritating in that condition. If you stand there grinning carelessly, it will only make them angry. You must be able to understand a person’s pain.”
“I don’t tell young people to do this now, but when I was young, I once stayed in the hospital for about three weeks straight. Because I didn’t have the skills, all I could give back to patients was my sincerity. If something happened when I wasn’t there, I worried. It was easier just to stay by their side. And because I knew so little, I had no choice but to study.”
For TOHDA, curiosity remains essential. “Children are always asking why things are the way they are. I want students who can keep that same sensitivity alive within them.”
TOHDA is also a pioneer among graduates of Kindai University Faculty of Medicine, carving a path for those who would follow.
“Unless there are many Kinki University graduates succeeding, the university and hospital cannot grow stronger. I wrote papers desperately, motivated by not wanting to lose to those from other universities. I never wanted people to say I only became a professor because I was a Kindai graduate.”
“I know I can be forceful, and that means I make enemies too. But I’m the type who will fight for my allies and drive back opponents. When a new professor comes in, this is what I tell them: If there’s something you want to do, tell me. If I agree, you can do it under my responsibility as hospital director. If I say no, then step back quietly. And if you still want to do it, then try to convince me.”
As an “eldest son” of Kindai University Faculty of Medicine, TOHDA Yuji continues to fight—and will no doubt keep on fighting in the years to come.