第16回：脳神経内科かしわば病院　−新築移転決定！−

脳神経内科かしわば病院　−新築移転決定！−

北海道大学神経内科の歴史を簡単に振り返ってみる。1973年北海道大学脳神経外科教室の中に神経内科診療班が誕生する。その中心にいたのがClevelandやSt. Louisで5年間のNeurologyの研修を終えた田代邦雄先生である。（旧）柏葉脳神経外科創設者の柏葉武先生と田代先生との縁は深く、1968年に釧路労災病院の初代部長として赴任した柏葉先生と田代先生は二人体制で釧路での激務をこなしている。田代先生は当時からNeurologyの造詣が深く、柏葉先生はニューロベーチェットという病気を田代先生から初めて教えてもらったと同門会誌に記載している。その後14年の歳月を経て1987年に神経内科は診療科として独立する。私は1988年に脳神経外科教室に入局しているので出来たばかりの神経内科を垣間見ている。垣間見ていると表現したのは、病棟では本当に一つの部屋をパテーションで区切って２つの診療科が同居していたからだ。私は同期8名と入局したのであるが、毎日罵声を浴びせられる我々と垣間見える穏やかでアカデミックなカンファランスを行う神経内科との違いに愕然として、8人ともが診療科を間違ったと思っていたが、怖くてそれも言い出せなかった。そんな我々を同じく神経内科に入った同期達はいつも慰め、励ましてくれていた。脳外科の退局者が続出しなかったのは彼らのおかげである。その後さらに8年が経過して神経内科は大学の講座を開設するに至る。その後神経内科の医局には優秀な医師が数多く入局し、診療、教育、研究が盛んに行われている。現在教室を率いるのは第３代教授、矢部一郎先生である。

神経系の疾患を扱う脳神経内科、脳神経外科の診療科が協力体制を築くことは上述したような教室の開設の流れから考えてもごく自然な流れである。2019年にまず脳神経外科病院の新築移転計画が南平岸に決まった時から、個人的な恩返しも含めて神経難病治療を中心とする脳神経内科病院を新築したいという構想を持ち続けていた。そんな時、2023年12月に北海道大学が保有していた平岸住宅の土地が賃借に出されるという情報が入った。その土地は外科病院と道路を１本挟んで斜向かいという信じられない幸運に恵まれた。我々は全力でプロポーザル入札に臨み、そして優先交渉権を獲得して2024年9月に北海道大学と土地賃貸借契約を締結した。2024年12月1日、脳神経内科かしわば病院は旧柏葉脳神経外科病院の母屋を借りる形で診療をスタートした。そして満を持して新築移転に向かう。新病院は2026年11月に着工、2028年3月に竣工予定である。

内科と外科が対になって診療する姿は循環器内科と外科のそれに重なる。個人的には内科がより積極的になり外科がより保存的になっていくのが医療の成熟の形ではないかと思っている。二つの病院が両輪となって北海道の神経疾患治療を牽引する姿を思いながら金策に走ろうと思う。志を同じにする多くの職員に南平岸に集まってもらいたい。Our voyage goes on!

2026年9月

社会医療法人柏葉会 理事長

寺坂　俊介

Kashiwaba Neurology Hospital— Decision Made to Relocate to a New Facility! —

Let’s take a brief look back at the history of the Department of Neurology at Hokkaido University. In 1973, a neurology team was established within the Department of Neurosurgery at Hokkaido University. Dr. Kunio Tashiro who had completed a five-year neurology training in Cleveland and St. Louis was a leader of the team. Takeshi Kashiwaba, the founder of the (former) Kashiwaba Neurosurgery Hospital, had a deep connection with Dr. Tashiro. Dr. Kashiwaba was appointed as the first department head of the Kushiro Rosai Hospital in 1968. He had worked together with Dr. Tashiro as a team to handle the demanding workload day and night in Kushiro. Dr. Tashiro had a deep understanding of neurology even back then, and Dr. Kashiwaba wrote in the alumni association journal that it was Dr.  Tashiro who first taught him about a disease called Neuro-Behcet. Fourteen years later, in 1987, the neurology team had become an independent department.

I joined the Department of Neurosurgery in 1988 and had gotten a glimpse of the newly established Department of Neurology.

I described it as “a glimpse” because two medical departments had been sharing a single room divided by a partition on the same ward.

 Eight new residents of neurosurgery were stunned by the stark contrast between our daily ordeal of being yelled at and the calm, academic conferences we glimpsed taking place in the neurology department. All eight of us thought “we’d chosen the wrong specialty”, but we were too scared to even bring it up. New residents of the neurology department had always encouraged us. We had great thanked to them to prevent us to drop off from the neurosurgery department.

Eight more years had passed, and the Department of Neurology eventually established a university department. Since then, many outstanding physicians have been turned out and clinical care, education, and academic research have actively pursued there. The department is currently led by its third professor, Dr. Ichiro Yabe.

Given the process described above regarding the establishment of these departments, it is natural that we collaborate to treat disorders of the central nervous system. After a project, new neurosurgical hospital transferred to Minami-Hiragishi, was finalized in 2019, I have continued having the vision of a new neurology hospital especially focused on the treatment of intractable neurological diseases. Honestly, I ‘d like to repay a favor from the past. Around that time, we received information that the land for the Hiragishi Housing Complex, owned by Hokkaido University, was to be leased out in December 2023. I thought we were incredibly lucky that the property was across the street from a surgical hospital, divided by a single road (not partition). We gave our all to the proposal-based bidding process, secured the preferential negotiation right, and entered into a land lease agreement with Hokkaido University in September 2024. On December 1, 2024, Kashiwaba Neurology Hospital has begun providing medical services. And then, after careful preparation, we are going to move into our new building. Construction of the new hospital is scheduled to begin in November 2026 and will be completed in March 2028. The collaborative approach between internal medicine and surgery mirrors that seen in cardiology and cardiovascular surgery. Personally, I believe that the maturation of medical care is characterized by internal medicine taking a more proactive role and surgery adopting a more conservative approach. I’ll set out to raise funds, keeping in mind the vision of these two hospitals working in tandem to lead the way in the treatment of neurological disorders in Hokkaido. I would like to see many like-minded staff members gathering in Minami-Hiragishi. Our voyage goes on!

Sincerely,

Chairman, Hakuyokai Social Medical Corporation

Shunsuke TERASAKA、M.D.