Psychological Rescue : Kobe: At hospital, Southland medical team shares its quake experiences with staff, awakens similar emotions.

After hiking seven miles through some of this city’s most ferociously flattened neighborhoods, half the 18-person Southern California medical relief team finally got to help Tuesday: At a Koreatown hospital, they peeled vegetables, straightened X-ray files, sterilized surgical equipment and conducted a grief therapy session.

And they were welcomed with hugs, tears and praise.

“They rescued us,” said Dr. Jung Hyo Kim, emergency room chief at Kobe Asahi Hospital, of the surprise assistance. “Our trauma team needed critical care, and the American doctors somehow appeared when we needed them most.”

On Monday, some of the U.S. visitors had been so frustrated in their attempt to heal the wounded of Kobe’s massive earthquake that they had threatened to leave. But Tuesday afternoon, the group clearly had its most profound impact. It came during the bereavement therapy session, which was attended by about 20 Kobe Asahi doctors and nurses.

Northridge Hospital Medical Center emergency room physician Ed Lowder started the workshop by describing his experiences during last year’s Northridge earthquake. Then he invited the Japanese doctors and nurses to explain to each other, for the first time, how last week’s quake had affected them.

Men and women who appeared as stoic as stone crumbled into tears as they described working for seven days straight after losing mothers, sisters and brothers in the catastrophe. They expressed shame over quarrels they’d had as stress built at home and on the job. Soon the whole room was bawling, as each story seemed more harrowing than the last.

One local doctor spoke of the guilt he felt at working 16-hour days at the hospital and ignoring his family and non-critical patients. Dr. Kim admitted he had erred by once describing to a colleague how nice it was to commute home to Osaka and have a warm bath, without realizing how that hurt staff members whose homes had collapsed.

The group seemed especially grateful for the bereavement advice offered by Dr. David Tharp, a British-born American living in Tokyo who has served as a liaison between the Kobe health department and the U.S. medical team. A mental-health expert who specializes in grief counseling, Tharp told the Kobe Asahi staffers that their problems would ease if they quit working so hard to solve them.

“Dr. Tharp is right, we must create a break chart instead of a work chart right away,” Dr. Kim told his doctors and nurse in his own summary remarks. “We must force people to take time off. Doctors are beginning to distrust each other because they are so tired. The source of our friction is exhaustion. We must accept these volunteers and take a rest.”

The Americans had been organized less than a week ago on the premise that Japan needed trauma-care specialists to assist in the treatment of the Kobe earthquake’s 50,000 wounded. Upon arrival in the city, however, the gung-ho emergency room doctors and nurses discovered that their Japanese counterparts had a much narrower view of volunteerism.

It is a foreign concept in this stubbornly self-reliant society; hospitals in one section of town don’t even like to accept help from physicians in other sections, much less from other regions of the country, or the world. The first day the Americans reported for duty, Kobe municipal health officials shuttled them from meeting to meeting at department headquarters before letting them visit (but not treat) what one nurse derisively called “cough-and-cold patients” at one refugee center clinic for a couple of hours.

Stung by news reports of the doctors’ unease, the city on Tuesday dispatched half of them to Kobe Asahi Hospital, an institution in a low-income neighborhood that residents say is typically ignored by officials.

Their arrival was a bit clumsy, as Japanese health executives tried to figure out how to accommodate colleagues whom they considered guests more than assistants. But during a tour of the building, Universal Studios first-aid nurse Jim Davis spied the kitchen--and asked to help prepare meals. He was quickly put to work measuring rice and cutting radishes.

Northridge Hospital critical-care nurse Charles Fife volunteered to help in central supply. Northridge’s Lowder picked up X-rays that had spilled out of a cabinet and had been on the floor for days. He also flattened cardboard boxes for garbage pickup. Northridge anesthesiology chief Steve Cantamout helped to clean the operating room.

During the bereavement session, Tharp also advised the Kobe Asahi staff that they would feel better if they smiled more.

“This is very good advice--very timely,” said Kim to his staff. “You do not smile because you do not think you have the luxury to smile. But the act of smiling can change your emotions. It is important that we be cheerful and set an example for our community.”

Later in the day, Kim appeared near tears again as he said Tharp’s words articulated emotions that had been boiling near the surface of his own mind, and that he felt “rescued psychologically” by the American doctor.

By the end of the day, the Americans had more concretely promised to lobby the U.S. consulate to urge the U.S. Army to send a water truck to fill the tank at Kobe Asahi. Lacking water, the hospital has put off 135 surgeries over the past week.

Dr. Kim drew the line of his welcome at the notion of asking the Americans to help with rounds or in the operating room, noting that the differences between the two countries’ practices were too great.

“Our systems totally disagree, for instance, over how long a patient should remain in the hospital,” he said. “An American might say that some guy should leave in two days while a Japanese would insist that he stay two weeks.”

Instead, the two sets of physicians agreed to meet the next day to discuss handing off the job of scrubbing the operating room.

Remarked Lowder about the past two days’ experience, which had culminated in a seven-mile hike in the dark back to the U.S. team’s home base on a Japanese coast guard cutter: “It was like climbing Mt. Fuji. We were going to get our chance to help, but we had to work for it.”