Q&A with TOMODACHI Program Participants and TOMODACHI Alumni: Kei Imai
Kei Imai is an alumnus of the TOMODACHI Disaster Resilience Leadership Training Program and is currently a researcher in a laboratory at the Department of Clinical Epidemiology and Economics, Graduate School of Medicine, at The University of Tokyo. He is also a researcher at the Division of Nursing Science, Graduate School of Health Systems and Integrative Sciences, at Okayama University. Through his many experiences, Kei has been working in two main areas: emergency and intensive care. He also won second place for his research paper presented at a conference of the Society of Intensive Care Medicine, and he hopes to use the discoveries and insights he gained during her long period of research as the basis for his future goals.
What made you decide to pursue a career in nursing?
When I entered university, I had no intention of pursuing a career in nursing. I was actually more interested in the area of public health. I could have studied law or a different discipline to do that, but I thought it would be better to have some knowledge of medicine. There are a variety of medical universities, but I thought it would be easier to go into public health because it would take four years to finish relatively quickly, and even a master’s degree would take six years, so I enrolled in the Department of Nursing at Sophia University. At first, I had no intention of pursuing a career in nursing at all. So at first, I didn’t understand or find the classes interesting, and I thought it would be quite difficult. When I went to the emergency center of a university hospital for training, I met a patient who was very seriously ill, and I could not find the answer to what I can offer for that patient. I decided to go into nursing instead of public health because I thought it would be good for me to take the path of nursing until I could find out what I could do.
What were some of the difficulties you encountered in your nursing career?
In terms of hardships, when I was in my second year of work, there was a worldwide pandemic (COVID-19), and I was asked to establish a COVID-19 ward. I had been to Okayama, Kumamoto, and Fukuoka as part of the TOMODACHI DRT (Disaster Resilience Leadership Training Program), and I had the opportunity to participate in the program there. I was asked to work with them on the construction of a new COVID-19 ward based on my experience in the program. I started working on building the ward, creating manuals, and teaching the hospital staff. When we built the ward, I thought it was a lot of work. I usually work in the area of emergency and critical care nursing, and of course there are people who come there who are able to walk home and go home in good health, but not all of them are like that. I still remember that there were times when people were not getting better even after treatment, or even though they tried hard, they did not get better, and they were living in great pain.
What made you interested in decision-making/psychological care?
In the intensive care where I usually work, not everyone gets better and leaves the hospital feeling happy. Many people are discharged from the hospital in such a way that they are no longer able to do the things they used to be able to do; they can no longer eat food even though they used to be able to eat, or they die unexpectedly. People who have never thought about medical care or life and death suddenly find themselves in such situations. But people don’t die that easily. They gradually lose the ability to receive various medical treatments, or they get sicker and sicker, getting better and getting worse repeatedly, and eventually die. Their families are also hurt, and people who were able to drink, eat, and walk by themselves may lose their legs. I have met many such people, so I thought it would be good if I could learn a little about such areas and be of some help.
Through your experience with the TOMODACHI DRT (Disaster Resilience Leadership Training Program), what made you decide to pursue your current path?
I participated in the TOMODACHI Initiative program for the first time in 2013. I was still in high school at the time, and since I had no connection to Tohoku and was born in Tokyo and raised in Yokohama, I knew nothing about anything far from home. However, when I saw terrible things happening on the news, I was very hurt by the fact that there were so many things that were beyond human control. It was at that time that I had the experience of going to the U.S. from Yokohama, and that was the first time I got involved with the TOMODACHI Initiative. There was no alumni program at first, because there were no alumni yet. After some time, in 2014 or so, a number of alumni began to gather, and a program for alumni was established. I met many people from Fukushima, Miyagi, and Iwate prefectures who had lost their family members to the tsunami or earthquake, suffered damage themselves, or were forced to flee to the Kanto region due to the nuclear accident. I met many people who had lost family members in the earthquake, suffered damage themselves, or were forced to flee to the Kanto region because of the nuclear power plant accident. I learned about disasters there and thought that I would be able to help in any way I could when a disaster occurred.
What is the research content of the paper you presented at the Society of Intensive Care Medicine?
Patients in intensive care units sometimes develop a condition called delirium. Patients with delirium may experience hallucinations, depression, or PTSD. They may also experience a decline in cognitive function, making it difficult for them to do simple calculations, for example. Also, the patient may have trouble remembering things that are said to him at work, and may forget them immediately. It is known that delirium can be prevented by taking various measures. However, we do not know which patients will develop delirium. We don’t know what the future holds, so I decided to create a program that uses artificial intelligence to find out which patients in the intensive care unit are suffering from delirium, and I created that program.
Did you have any difficulties in writing your paper?
People often say things like, “Isn’t it hard to create a program?” However, I think that this is probably the least difficult part of most research. I think it is the same for all jobs, such as working as a nurse, but the hardest part is the preparation in advance. For example, in my case, I wrote the program myself using a Python program, and of course it was difficult to study it, but what was more difficult was taking the data to put into the Python program and examining it carefully to see which data was correct and which was incorrect. I had to make sure that the data was correct and correct, and I had to do a lot of careful examination of the data by myself. So I spent about 80% of my time taking that data, and the remaining 10% writing the paper.
Do you have a message for those who want to pursue a career in nursing?
I think it is important to know yourself well. If you don’t know yourself, you will force your values and what is important to you on your patients, and if you don’t know what is important to you, you will end up hurting someone else. So I think it is very important to know yourself first. The other thing is to have various experiences. The reason for this is that people live only a short time when they need medical care, such as going to the hospital. There are people who spend years in the hospital, but they spend more time with their family and friends than they do thinking about their illness. So while it is important to study seriously about medical care and nursing, it is also important to learn from the people you would not normally meet, and gain various experiences. By learning the opinions of various people, you will be able to better understand people who suddenly need medical care in their daily lives. I think it is very important to have this kind of experience.
What are your goals for the future?
There is something called Post Intensive Care Syndrome (PICS). Of course, some patients who enter the intensive care unit or come to the emergency room do get better, but they suffer a lot when they enter the intensive care unit or receive treatment there. However, when they enter the intensive care unit or receive treatment, there is a high possibility that they can develop delirium. My goal for the future is to eliminate PICS. It is very painful to have PICS even though the patient has worked hard in the intensive care unit to get better and regain his or her normal life. Of course it is important to save lives, but that is not why we are here. It would be best if we could be happy, walk by ourselves, eat good food, spend happy time with our family, and live in peace without PTSD symptoms that keep us tormented by painful traumas. PICS has been often overlooked in emergency or intensive care facilities in the past. But now, with advances in medical care, the number of people who receive intensive care and are saved in the emergency room and are discharged from the hospital alive has increased. This means that the number of people suffering from PICS has also increased. So there is a situation in which PICS has not been given much attention until now. I would like to do some research on the causes of PICS and how it can be prevented or reduced. In order to do this research, I need to develop my own research skills, so my goal is to continue to do research that will be useful to society through proper study and research at graduate school.
This alumni highlight interview was conducted by Nina Takanami on April 9, 2025. Nina is currently an alumni intern with the TOMODACHI Alumni Leadership Program.
