Doctor Gon: The Island Physician Bringing Modern Care to Okinawa’s Remote Shores
A dedicated physician, known as Doctor Gon, provides vital medical services to the aging populations of Okinawa’s isolated islands, pioneering a model of compassionate, home-based care.
For nearly three decades, Physician Yasukawa Keigo – affectionately known as Doctor Gon – has been a lifeline for the elderly residents of Miyako Island and its surrounding isles. Providing everything from routine check-ups to end-of-life care, his commitment extends to the most remote corners of Okinawa Prefecture, where access to healthcare is a significant challenge.
A Vital Safety Net on Ōgami Island
Tiny Ōgami Island, a mere four kilometers off the coast of Miyako, holds a unique place in local culture. Revered as the home of gods and steeped in religious tradition, the island hosts special festivals that honor its sacred status. Traveling aboard the ferry to Ōgami with Yasukawa, a 62-year-old physician, reveals the dedication required to serve this dwindling community. Once home to over 200 people, Ōgami now has fewer than 20 residents, with nearly a third aged 75 or older. Reaching the island can be difficult, even by ferry, and Yasukawa recounts instances where he’s had to resort to a jet ski during emergencies.
The fifteen-minute ferry ride from Miyako Island offers a glimpse into the logistical hurdles of providing care. (© Ōnishi Naruaki)
Upon arrival, an elderly resident greets the medical team, a testament to the trust Yasukawa has cultivated over years of service. (© Ōnishi Naruaki)
The concern etched on the face of a wife watching over her husband’s health underscores the importance of accessible medical attention. (© Ōnishi Naruaki)
Yasukawa recalls initial resistance from the islanders, rooted in a tradition of protecting their sacred sites by limiting outside access. “To protect the holy sites,” he explains, “I became friends with an elderly man who worked on the ferry, and his mother became my first patient there.” For two years, she was his sole patient on Ōgami, but through consistent visits, he gradually earned the community’s acceptance.
Based at his Dr. Gon Clinic, Yasukawa extends his services to Miyako and its five surrounding islands. While bridges connect four of these islands to Miyako – Irabu Island being the most recent addition in 2015 – Ōgami remains accessible only by sea. Frequent ferry cancellations due to weather conditions haven’t deterred Yasukawa, who remains steadfast in his commitment to serve the island’s residents for as long as they remain.
During a visit to Isa Teruo, 75, who returned to the island to care for his aging mother, the sentiment is clear: “Dr. Gon Clinic acts as a safety net for the people of Ōgami.” While Miyako Island boasts two general hospitals, the effort required for elderly patients to travel there is substantial, making Yasukawa’s home visits invaluable. Three residents currently receive ongoing home care from the clinic.
Yasukawa conducts a check-up for Isa Tsuru, 95, with her son, Teruo, observing with concern. (© Ōnishi Naruaki)
After a two-and-a-half-hour visit, Yasukawa returns to Miyako, prepared for the next call to service.
The Deep Significance of Home Visitations
Accompanying Yasukawa on consultations around Miyako and the neighboring islands reveals the heart of his practice. Entering the home of a nearly 100-year-old patient, he announces with warmth, “Grandma, Dr. Gon is here.” His check-up is accompanied by reassuring conversation. “How have you been? I’m going to give your heart a listen. Deep breaths! Your heartbeat is fast. We can’t have you getting a blood clot and having a stroke. I’ll prescribe some good medicine, so you’ve nothing to worry about.”
Yasukawa frequently concludes his visits with the Okinawan phrase jōtō-sa, meaning “everything is fine.” This simple reassurance, he believes, is often as effective as any medication.
He emphasizes that modern medicine’s reliance on extensive testing shouldn’t overshadow the fundamentals of good health: proper nutrition, adequate rest, and a grateful outlook. Recognizing a patient’s living environment – their hygiene, eating habits, and family relationships – is crucial for effective medical consultation, making home visitations particularly impactful.
With home visitations, staff and family members work together to support the patient’s well-being. (© Ōnishi Naruaki)
Yasukawa’s final words of assurance, “everything is fine,” provide comfort and peace of mind. (© Ōnishi Naruaki)
Caring for an Army of Elderly Patients
Born on Miyako Island in 1963, Yasukawa followed in his father’s footsteps, a physician who researched filariasis and traveled extensively for his work. After initially struggling with college entrance exams, he earned his medical degree from Kyōrin University School of Medicine in Tokyo. He then worked in the Department of Critical Care and Emergency Medicine at Tokyo Women’s Medical University, where he saved countless lives but also confronted the limitations of critical care, witnessing patients who never fully recovered or remained in a vegetative state. This led him to question whether he was truly saving lives or merely prolonging dying. A colleague’s dismissive label – “vegetable maker” – further fueled his introspection.
Later, as medical director in the emergency department at a hospital in Ibaraki Prefecture, he began making home visits to critically ill patients post-discharge. This experience solidified his confidence in providing advanced care, including surgical techniques, within the comfort of a patient’s home.
In 1997, Yasukawa returned to Miyako Island and established a clinic in the main town. Three years later, he founded Dr. Gon Clinic in Ueno, a previously doctorless town in the island’s south, embracing his childhood nickname, “Gon-chan.” This marked a dedicated focus on home visitations.
Dr. Gon Clinic, recognizable by its traditional red-tiled roof, now employs three doctors and eight staff members. (© Ōnishi Naruaki)
Over the course of his career, spanning emergency medicine and 28 years at his clinic, Yasukawa has cared for over 10,000 patients in the final stages of life. He now embodies the principle he articulated in his 2004 book, Nihon de ichiban shiawase na iryō (Japan’s Happiest Medical Care): recognizing that some lives are meant to be saved, while others require quiet, compassionate care.
Harnessing Technology for Remote Care
The increasing demand for home medical visitation has spurred the development of compact, high-performance medical equipment. Patients who once required hospitalization can now receive comprehensive care at home. Yasukawa’s visitation vehicle is equipped with a portable electrocardiograph, an artificial respirator, and a micro-volumetric drug infusion pump. He relies heavily on his ultrasound diagnostic equipment, using it to examine abdominal regions, the heart, and the bladder. Connected to a smartphone or tablet, this technology enables him to diagnose ailments, administer emergency treatment, and even perform simple surgical procedures. He can also assess ophthalmological disorders using specialized smartphone attachments.
Yasukawa’s vehicle is meticulously stocked with medicines and essential medical equipment. (© Ōnishi Naruaki)
Yasukawa utilizes portable ultrasound equipment during a patient examination. (© Ōnishi Naruaki)
Home Visitation: A Collaborative Effort
This comprehensive service relies on a specialist team – doctors, nurses, rehabilitation therapists, carers, and home helpers – working in concert. Yasukawa can seamlessly transmit diagnostic information, prescriptions, and other vital data from a patient’s home to hospitals, pharmacies, care managers, and other involved parties. He utilizes a network system, adapted from his experience at Tokyo Women’s Medical University, to enhance treatment efficacy through improved information sharing.
An effective electronic medical record network is fundamental to successful home medical visitation. (© Ōnishi Naruaki)
The clinic staff gathers each evening to share information and coordinate care plans. (© Ōnishi Naruaki)
Eight years ago, a home nursing service was established to support Dr. Gon Clinic. Nurse Tomari Mika is central to this service, providing around-the-clock support and accompanying patients in their final moments. Last year, the service provided end-of-life care for over 60 patients, roughly one per week.
“When a patient passes away, we wash the body together with the family,” explains Tomari. “Taking the time to provide this extra care, to make them look their best in death, is also therapeutic for the grieving family. Being present at the deathbed is a special opportunity to recognize a person’s life with the family. It’s also satisfying as a nurse.”
Tomari Mika, a key member of the home nursing service. (© Ōnishi Naruaki)
Dr. Kobayashi Jun’ichi, 31, who has been working at Dr. Gon Clinic for six months, accompanies Yasukawa on home visits, specializing in gastroenterology and seeking experience in medical home visitation. He plans to return to his family’s practice in Hyōgo Prefecture to focus on in-home care, stating, “There is so much I can learn from Dr. Yasukawa.”
To attract new staff, Yasukawa opened another clinic in Kamakura, Kanagawa Prefecture, in 2004. Recruiting medical professionals on Miyako Island is challenging, but Kamakura’s proximity to Tokyo makes staffing easier. He invites staff from the Kamakura clinic to assist on Miyako, drawn by the subtropical setting and the warmth of the local community. Experiencing this unique approach to medical care allows them to re-evaluate their roles as healthcare professionals. As Japan’s population ages, these innovative models of care deserve greater attention.
Yasukawa contemplates the view from an observation deck on Ōgami Island. (© Ōnishi Naruaki)
Yasukawa’s work takes him into the homes of his patients, where he witnesses the traces of lives lived and the enduring power of local memories. He reflects on the concept of chirei – spirits believed to inhabit the earth, fostering abundance and protecting the cycle of life – recognizing these islands as truly sacred spaces. Having witnessed the full spectrum of life, from emergency rooms to patients’ homes, Yasukawa understands that medical care extends beyond physical examinations; it’s a journey through the memories and stories of these remote islands.
(Originally published in Japanese. Banner photo: Dr. Gon performs internal examination using portable ultrasound equipment. © Ōnishi Naruaki.)
