This document was worked on by @RexLobo @will! @Oli @Yume_ , and brought together by the entirety of the lore team. Every person who put their part towards this work, a very special thank you!
Thank you @Nylu for the screenshots!
SYNOPSIS
Hospitals on the city-island of Izu-Karakura obtained existence thirty-four years after the westernisation of the Japanese Health Care system - the Meiji Restoration. A time when the Tokugawa shogunate found a final demise, and politics irked a sudden change with no space or time left to lose. Constant change left out of wallets along with the reflection of such sudden metaphorical earthquakes. The one thing from such renovation was the introduction of western medicine taking over the system, and Karakura had only caught up almost three decades and a half later, which set a certain knockback and few revolts over the time - nothing was ever truthfully considered by the dejected law-givers. During the drought of such a period - injuries sustained caused a hole in mortality rates, gaping wide like a shark biting at the sanity of the aquarium’s cage, begging to be free from the depression. Physical refuge sought after such time - an undeniable gift to such leftover land that the residents dared to call themselves acquainted with the differences in accessibility from the mainland.SYNOPSIS
In 1947-1949 Karakura, the person ruling over this system apart from the government was a member of the high-ruling Otori ninkyo dantai, with nothing but truth that the police euphemism ‘boryokudan’ could’ve been needlessly used to help hide their love for such clan, aiming to publicly shun anything that claimed the ‘Otori’ name had any relativity to such gruesome moniker. By 1950, the Postwar Crime saw the Otori family take over the public services of Karakura, restlessly, rapidly and reflexively. A bad time for such high-reward development of health service in particular with every single teardrop of effort from Hisako, the director, as there were non-negotiable medicines that would not be cruising over to the island at any time until the reign of such dynamic business seized inertia.
Taisho and Early Showa Period (1912 - 1945)
With the Second Karakura Crime Wave in full effect, morale on the island was at an all-time low. There was an influx of injuries, with the only way to seek treatment being select doctors who had long retired from their positions and moved away from the mainland onto the island of Karakura. It was these retired doctors who came up with a decision to come together to help the people of Karakura. In 1912, the Karakura Clinic was established. This clinic was not large by any means at first, simply having a few tents that held medical equipment to treat injuries and administer medicine. However, it eventually grew with the help of the people of the island, working to further organise the clinic into a proper medical centre. Volunteers and apprenticeships began in early 1913, allowing the growth of the clinic.View attachment Add a heading (1).jpg
However, with the First World War occurring in mid-1914, many of the volunteers and apprentices were drafted into the war. This once again left the clinic scrambling for more manpower. The clinic had lowered its restrictions for individuals, allowing those who were below the age of the draft to begin to practise medical procedures within the clinic. Following the conclusion of World War 1, only a handful of those who worked with the clinic returned to Karakura. Still, the clinic worked hard to treat all the veterans who had returned, assisting them in any injuries brought onto them by the war.
Two other notable events spiked the activity of the clinics: The earthquake of 1924 and the 1935 rockslide. This natural disaster devastated the people of Karakura, leaving most of the city in shambles. Many lives were lost, and even more were left injured. The clinic was one of the areas that opened its doors to refugees, as well as sending its doctors to the Itsbyoshi castles to treat the injured who were housed across the island. This act of generosity by the clinic led to the people putting more funding into it, allowing more developments to occur on the island. This was then followed up by the rockslide of 1935, which led to the deaths of 56, and injuries of many more. The doctors worked to treat as many as they could, but not everyone was able to be saved. Of the 56 fatalities, 23 were individuals who passed during treatment.
When World War 2 occurred, Japan went through much tension and struggle. With the mainland fully involved in the war, the island of Karakura was left to fend for itself. Throughout the war, there were three cases of bombings, which left the population in fear. The first bombing in 1941 left many fatally wounded, with only a dozen civilians deceased. This case was believed to be the only one during the war, as the citizens remained out of the war, aside from those drafted. This thought was short-lived, as the second bombing in 1943 left much more destruction in its wake. With the town center being struck, there were hundreds of injured, with nearly as many fatalities. The citizens tried to come together to further establish the clinic into becoming a proper foundation, but its efforts were halted in pursuit of rebuilding. The final bomb struck the Kaigan coastline, which left no fatalities, but further established a need for a proper facility. With the end of the Second World War, the people of Karakura finally came together to create the first hospital, with the construction beginning in late 1945.
The Otori Corruption (1946 - 1956)
The first sign of true unity in Karakura occurred after all these tragedies. The people all came together to form its own true body of government on September 3, 1946. With governors elected to take charge of the citizens of Karakura, things began looking up. This group oversaw the creation of the Karakura Police Department, Karakura High School, and lastly, finalised the creation of the official Karakura Hospital.The hospital began as a neutral entity, led by Yada Higashi, once it was recognized as the main medical body of Karakura. Higashi was one of the first apprentices under the main doctors who led the clinics. With his knowledge, and newfound funding by the government, commissioned mainland doctors to properly teach the current doctors on the island with the vast knowledge of medical care from Japan. Training routines were developed and every new doctor had to go through the training process. At the time, there were only two departments, doctors and surgeons, both specialising in their own procedures. Doctors treated illnesses, while surgeons treated injuries.
During the rise of the Otori family, the hospital remained neutral through the wishes of the director at the time, Yada Higashi. The director prided himself in the hospital's ability to aid injured and sickly citizens, no matter who they were.
After the finalisation of each esteemed institution, it was clear Higashi’s mind was deteriorating with his old age, leading to the appointment of a new director. At first, it was argued between the
The Yagi family was known for their general warm-heartedness, which transferred to their hospital work. It was pretty clear that even with promising work and offered health care, the Otori administration was displeased by the choice of director. Though, they were not going to openly display their opinions. Rather, they chose subtle ways to pressure the director into resigning to take control over another institution. Small instances that continuously piled up, medical expenses that could not be paid indefinitely, costs that needed to be supplemented. In the meantime, Governor Tetsuya Otori put another member of the family in the hospital workforce. Hisako Otori easily worked his way up to clinical lead by the time the tension within the hospital bottlenecked.
At this point, the Otori family sunk their claws into the hospital, providing funding but taking a stake of the hospital in the process. Slowly, Yasue was stripped of their powers until their forced resignation in 1949. Hisako Otori took over as director at that point in time, leading to a complete government takeover. To continue to fuel the Otori’s image, they completely renovated the hospital, bettering its equipment, putting funding towards better medicines, and much more.
Still, secrets are meant to be uncovered. In 1954, news of the family’s misdeeds were spread across the island due to an investigation by Karakura’s police department. Even with Inaba Otori in the captain’s seat, it only delayed the inevitable for some years. After the facts came to light, Hisako was forced to surrender their director seat back to Yasue Yagi. Yagi made knowledge of the events of his resignation public when it was safe to. Thus was the end of Otori’s era in the hospital.
Itsbyoshi Rise and Education Boom (1956-1987)
With the end of the corruption that enshrouded the hospital and the entire island alongside it, Yasue Yagi shrouds the past with all of her might. Every single day, tiresome for the workers of Karakura Hospital. Undoubtedly, it had been one of the most horrid times for them. Not due to the severity of the citizens' injuries but because the trust had evanesced. The trust that held health by heartstrings, tied with the tree of the government where branches had acted as each officer. The connection was lost - now it had been restored. And with her healing hands, Director Yagi collapsed too, the paranormal activity. Shrieks of the dead now reveal themselves as simply passers by, back to each grave where they came from as the morgue is silenced.Still, with all good things come an end. Director Yagi passed soon after all these events, and sparked his apprentice, Tenzo Ichikawa, to take over. Ichikawa was a man invested in medical practice, and was a spearhead in advancements in Karakura. New training programs were implemented, trainees were scheduled to watch all his procedures to ensure them the best opportunities to learn.
With the establishment of the Karakura Community College at the beginning of the 1980’s, the hospital took a hands-on approach with students. Ichikawa stepped in, assisting in the education of the medical students at the school. All medical personnel were invited to present hands-on experience in join with the professors at the college., fostering a relationship between current and future practitioners and the school itself. After two years of this arrangement, Senior Leadership of the community college held their first internships for medical students to work at the hospital. Furthering the collaboration between both entities.
Near the end of the century, at the end of the Education Boom, Tenzo Ichikawa chose to step down of his own accord. While he enjoyed his position, he believed there was more that could be done elsewhere, and chose to leave the hospital in the hands of their most senior higher-up, Shoji Hinatabi.
Westernisation (1987-2006)
This decision was not the greatest, and thus began the fall of the hospital. Hinatabi was a greedy individual, seeking to grow a fortune, even at the expense of those around him. His ideals were inspired by the west, seeking profit over their goal of saving lives. Every procedure done by the hospital must have been paid for. This added price on life-saving practices and procedures drove many residents of the island to debt. As the only hub of medical treatments without traveling to the mainland, they were forced to pay these exorbitant fees.
It took some time, but the hospital itself began seeing itself being run down. Medicines were expiring when they should have been replaced with newer ones. Equipment was not being maintained, and employee morale was at an all-time low. Mayor Okazaki Satoshi employed the current Detective Superintendent to look into it personally. It took around a year to uncover the truth of the embezzlement of the funds. By that time, Satoshi had stepped down. However, the news was released to the press, highlighting Hinatabi’s activities with the embezzled money. Following this, the hospital lost its funding and was put under new management. In this management, higher-ups were made more involved in decisions, all checked and balanced with the town hall, ensuring the hospital would not fall as far as it had.
The hospital received its first non-native director at the start of the century. An English man named Charles Silva had transferred from England to assist in rebuilding the hospital after its fall. While not the most notable individual, the reputation and trust in Karakura’s medical practice started being rebuilt from then.
Before the Storm (2006-2017)
Even with all the strives to repair the image of the hospital, it remained in shambles. The mortality rate of Karakura remained high, and many of the experienced doctors migrated to the mainland. Many students followed their mentors, leaving a scarce few to treat island residents. This sentiment remained, causing more to leave for better working conditions until the hospital was abandoned near the end of 2009. Anyone who remained on the island went their own ways and worked in general clinics all over the island, making treatments more available to all citizens.Modern Day (2017-2024)
After years of the hospital being shut down, groups of doctors banded together to create a convenience store named Happy Pills. A part-time position to aid the clinics with a central pharmacy for citizens to receive their needed medicines. It began with light painkillers or allergy relief, but they soon were the hub for medicines being imported from the mainland, distributing medicine to all the small clinics around Karakura.
A year later, a fantastical project reached out to Tenzo Ichikawa. The brain-child of his granddaughter Mikazuki that sought to bring the future to the present through ambitious development in bionics, under the family’s name. Ichikawa Bionics solidified the future of the family’s relationship with Karakura’s hospital through a mutual agreement on the experimental trials of such prosthetics. Karakura’s citizens could return to a near-normal life. To keep the costs low, the hospital and city paid the bionics company in both data and monetary gains. After a city-wide fundraiser the final stage of prosthetic eyes was reached, allowing those injured and blinded to regain sight, albeit without colour, after a rather swift medical trial.
As of recent, there have been a few director changes, ensuring the one in charge is most suited to the position. Currently, Rokku Heddo is the director of the hospital, and was the director who implemented the new and improved Ichikawa prosthetics.