Hibakusha

The clinic is at the summit of Hijiyama Hill, one of the highest elevations overlooking the city of Hiroshima. Halfway up the winding road, I pass a turnout that had been a favorite site for reconnaissance teams to obtain the first panoramic photographs of the city in August 1945. The 7 branches of the Ota River, demarcating the 6 island neighborhoods of the city, are starkly visible in those old pictures, as if on a topographical map. Not a building had been left standing seconds after “Little Boy” detonated 580 meters over the city. Since then the city has been rebuilt, but last night from this vantage point the branches of the Ota were again visible, illuminated by thousands of flickering candles floating down the tidal estuary as they have every year on the anniversary of the blast. I enter the military-style Quonset huts of the clinic to see my first patient.

Today is far removed from how I thought my internal medicine career was to begin. I am starting as a staff physician at the research foundation set up in Japan after the war. The foundation conducts a detailed population survey of the potential long-term health consequences among the survivors and descendants of citizens of Hiroshima. Now, some 20 years after the termination of the war, my role is to team with a peer Japanese physician. We jointly participate in the biennial medical evaluation of the patients, and come to agreement with each other on the objective medical findings; we are always blinded to knowledge of radiation exposure. I have been well trained for this assignment, have worked diligently to acquire a rudimentary facility with the Japanese language, and have carefully rehearsed the essential medical vocabulary for interviews. But at this moment I cannot get last night's candles out …