FRONTRUNNERS

This helicopter is vital to my work.

Breathe out... And again.

I'm so grateful to Dr. Tsugita.

I'm doing things that only I can.

People need that human touch, and that's my guiding principle.

Helicopter physician
Tsugita Nobuyuki

Momoshima is a small island in the Seto Inland Sea,

off the coast of Onomichi, Hiroshima Prefecture.

The island has a population of just 380 people.

And of those, some 70% are over the age of 65.

Declining birthrates brought the closure of the local elementary school.

And in 2005, the only medical clinic shut down too.

In Hiroshima Prefecture alone,

there are over 50 such isolated communities with no medical facilities.

But in 2011, a new doctor arrived on Momoshima.

(Momoshima Medical Center)

Tsugita Nobuyuki.

You in good health?

Yes.

Appetite OK?

Yes.

Any English for our overseas viewers?

English? No speak English.

Regular checkups here saved my life.

He found three blocked arteries.

Including one to the heart.

A heart attack.

Five years ago,

the patient came for a checkup

after experiencing discomfort in his chest.

Tsugita identified an early-stage heart attack,

and quickly sent him for life-saving treatment on the mainland.

Your heart is looking a lot better than before.

Looking good.

Let's try and maintain this!

Got it! Thank you!

This patient is receiving treatment for a liver condition.

Now a big breath out.

No dizziness lately?

No, but I have felt a bit sluggish.

Sluggish, huh? Show me your tongue.

I don't want to leave the island.

Though she could have gone for treatment on the mainland,

the patient preferred to receive care closer to home.

Try not to worry. We're here to look after you.

You live alone, but just get in touch whenever you need to.

Anxiety is one of the main things detrimental to your health.

It impacts various areas, like your appetite and your sleep.

It often sends people downhill.

No good comes from stress

so we place a lot of emphasis on keeping it at bay.

I'm heading out.

After two hours of consultations at the clinic,

Tsugita heads straight out for a round of home visits.

Sorry! The road's pretty narrow.

These house calls are vital to local people

unable to attend the clinic in person.

He arrives at the home of his oldest patient.

Ninety-nine-year-old, Okazaki Yasuko.

You look healthy.

Yup, thanks to you.

Looks great for 99, doesn't she!

It's all thanks to you.

- No dizziness or loss of balance?
- Nope.

- And you're eating OK?
- With gusto!

Well that's great to hear.

I'd like to join my husband soon, though.

I think there's a bit longer left in you!

Yasuko's daughter Kaori returned to the island to live with her.

Feel like eating lunch?

Having raised three children on Momoshima,

even after the death of her husband, Yasuko decided to stay here.

And Kaori is keen to honor her mother's wishes until the end.

I want to be there for my mother at the end. Of course.

But I can't look after her alone,

and I really believe the clinic has helped to keep her healthy.

Eight o'clock in the morning.

A nice clear day.

But today, instead of the clinic, Tsugita heads down to the shore.

This is vital to my work.

This helicopter is actually how Tsugita reaches yet another clinic

he runs on another nearby island.

He secured his pilot's license

and purchased the vehicle especially for this purpose.

Though helicopter medics exist elsewhere,

Tsugita is thought to be Japan's first to pilot his own vehicle.

With this, I can go anywhere.

The flight to nearby Sagishima,

where Tsugita opened his second clinic in 2018, takes just ten minutes.

Hi everybody.

And his local nursing staff are here to greet him.

Sagishima has a population of only around 600, and falling.

And like Momoshima, some 70% of locals are over the age of 65.

Tsugita's clinic is based in what was once the local school.

(Sagishima Medical Center)

And though it's still early, the waiting room is already full of patients.

How are you feeling?

Not so good.

What's up?

My back hurts.

Why? Did you fall?

I was weeding my garden.

How about a shot of painkillers?

Before Tsugita arrived,

Sagishima received only one weekly boat visit from a mainland doctor.

But now, consultations are available five days a week.

I don't know what we'd do without him.

It gives piece of mind to have this place open Monday to Friday.

It's tough for those with mobility issues to go for care on the mainland.

I'm so grateful that he comes here by helicopter.

Having seen to his morning patients,

Tsugita heads back to Momoshima for the afternoon shift.

The helicopter is crucial to his support

for both of these isolated island communities.

In love with the sky from a young age,

Tsugita Nobuyuki actually acquired a light sports aircraft license

while still in medical school.

And after graduation, instead of going into medicine full time,

he worked two days a week in a hospital

while focusing the rest of his time on an aerobatics team...

where he honed his skills as wingman

to the late great aerial display star, Rock Iwasaki.

The practice was incredibly demanding.

Just the slightest collision could have killed us both.

Most eschew such hazardous training but for us it was vital.

I feel like Rock gave up some of his nine lives to develop me as a pilot.

But this double life couldn't go on forever, and at the age of 30,

Tsugita walked away from flying to focus on his medical career.

And just two years later,

his former partner and mentor Iwasaki was killed in a training accident.

He was such a role model to me.

And at night his vision began to haunt me saying,

"I stuck it out till the very end.

Why did you leave the team, dammit?

There must be a reason.

Go find it!"

Searching for his true calling,

Tsugita resolved to incorporate his unique flying skills

into his medical practice.

It had to be islands like these.

A helicopter seemed the perfect solution for these dwindling communities,

and the perfect use for my flying skills.

In 2011, with the cooperation of local officials and residents,

he opened a medical center on doctorless Momoshima.

Then, in 2017, having committed to opening another center on Sagishima,

he set about acquiring a helicopter and license.

But at the time, Momoshima lacked a heliport.

These slopes were just wild.

Covered with trees. Like a jungle.

With no additional funding available from the authorities,

the local community mobilized to help.

They cleared all the trees.

They even laid the concrete and built this hangar.

The local construction boss wasn't too happy

at doing all the work for free.

"We're like volunteers," he told me!

I'm so grateful for that support from the community.

And I want to honor that spirit.

And for all 12 years since, Tsugita has lived here alone,

while his family remained on the mainland.

Wife Akemi, herself a doctor in Kobe comes to stay at weekends.

And, though constantly alarmed by her husband's exploits,

she gives her full blessing.

He's constantly trying something new.

New developments all the time. So there's never a dull moment.

This weekend, they're also joined by their daughter,

13-year-old Kokomi.

For dinner, father and daughter share a new experience.

Roasting a chicken together.

Looks great!

Wow. The stuffing's turned out great!

How does Kokomi see her father's work?

I see how hard he works every day at such a tough job,

giving his all for these elderly people,

and I really respect that dedication to his work.

I'd like to be like him one day.

First thing each morning, Tsugita always has one thing on his mind.

The weather.

Today looks a bit uncertain.

This is a live rainfall radar.

This afternoon, the rain looks set to worsen.

And if it gets too bad, he won't be able to fly.

It's looking heavy over southern Shikoku.

Having decided against flying, Tsugita sets out by boat.

See how low the clouds are?

Obscuring the mountaintops.

I'd have to fly at low altitude, below the clouds.

Safety first.

Of course. An accident would put a stop to my work.

In fact, when first starting out here,

Tsugita also made sure to acquire a boat license,

and he takes the helm himself for today's crossing.

With weather a constant threat to helicopter use,

the option to go by boat is an important backup.

He soon arrives safe and sound in Sagishima harbor.

And this mobility by air and sea

is central to Tsugita's support for these island communities.

Ahoy there!

Good morning.

We join him on a trip to the home of another long-term patient,

95-year-old, Kawamoto Shoso.

How's your appetite?

Normal.

And your sex drive?

Still there!

Dr. Tsugita's good fun. He jokes around with you. It's great.

And though he has had a number of health scares,

Tsugita's team is here to monitor his situation and guide him through.

Kawamoto is yet another patient living alone

since the loss of his spouse five years ago.

And while some infirm seniors enter the care of children on the mainland,

he is determined to stay on Sagishima.

These are some piquant pickles!

A former carpenter, he built this family home himself.

So many memories.

I'd never be able to leave here.

I want to stay as long as I can.

I've told Dr. Tsugita not to send me to the hospital if I fall ill.

I want him to care for me here till the end.

Today, Kawamoto's son and granddaughter are visiting from the mainland.

Son Tsuyoshi worries about his father,

and comes once a week to help out around the home.

He seems to want to stay here. It's where he was born and raised.

It gives great peace of mind to have the nurses and doctors here

to look after him whenever he needs them.

I trust them 120%!

Throughout Kawamoto Shoso's 95 years on Sagishima,

the sea has been a daily constant.

I come out here first thing each morning.

It really makes you glad to be alive.

There goes a seagull.

"Awakened by the cry of seagulls..."

He's in his own world, with his own life that he wants to enjoy.

And to him, being here is a big part of that.

He wants to stay here, and that's his choice.

He's absorbed in his own world here,

free of cares or loneliness, living as he pleases.

And we aim to help him stick to that laid-back lifestyle.

Back on Momoshima, Tsugita's clinic welcomes an observer,

medical student Ichikawa Koichi.

Across Japan, there are some 120 isolated island communities

that lack adequate medical provision.

So, in the hope that some may take an interest

in this distinctive line of healthcare,

Tsugita regularly welcomes students to watch him in action.

You sow the seeds, but most don't grow.

Not many youngsters want to come and live on islands like these.

Ichikawa accompanies Tsugita

to observe his sensitive in-home care for local seniors.

In Tokyo, you just can't imagine what healthcare is like here,

so I had to see it in person.

And today's patient is a familiar face, Kawamoto Shoso.

No dizziness or unsteadiness?

No particular worries?

He's a sixth-year medical student.

Your apprentice, huh?

- Such a cool old guy.
- He really is!

Every patient is different, so it's fun to talk to them!

All of them soldiering on, staying true to themselves.

That's the way!

Tsugita's aim is to show students the strong bonds

that can only be forged by working so closely with patients.

We got a call from one patient.

Something had happened to leave her feeling stressed and emotional.

But as soon as she saw Dr. Tsugita,

she was all smiles and said she felt at ease.

It left a really big impression on me.

That's been my number one insight into just how special Dr. Tsugita is.

And Tsugita's search for young recruits

for this aging community has recently received a boost.

Lie down for me, please.

Nurse, Nishida Yoshiko, joined the team earlier this year.

While her husband Yusuke also came on board as a receptionist.

Having previously worked on the mainland,

Yoshiko was so inspired by Tsugita's work on these islands

that she persuaded her husband to come and join her here.

I realized that I wanted to forge a closer relationship with patients.

I find working on these islands very fulfilling.

I'm home!

The couple relocated together with their three-year-old daughter.

And at present, they are based in the home of fellow nurse, Horimoto Yuko.

Bon appetit!

I was amazed that the three of them moved here.

But I'm also very grateful.

There are all sorts of people working to revitalize these communities.

So I hope we can support that from a medical perspective.

We feel a calling, and that makes us stronger.

You give your all as you know only you can.

And I think that's the conviction that underpins her work, too.

So, what is it that motivates Dr. Tsugita Nobuyuki

as a "frontrunner" in his field?

It has to be the smiling faces.

Of my colleagues, my family, my patients,

and the people on the islands.

You'd want to see them all smile, wouldn't you?

Wouldn't that make you happy?

For me, that's the ultimate driver.