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430printed on the certificate of completion of this workshop is depicted in Figure 4. At that time, the standardization of emergency resuscitation had just begun, and we were the first to launch the in-hos-pital emergency resuscitation system “J-STAT Call” with reference to our hospital. Currently, this program continues as a workshop, hosted by the Shizuoka Disaster Medicine Research Center, to instruct BLS and ACLS of the American Heart Association based on its international standards for education.Figure 4　Logo of the East Shizuoka ACLSFigure 5　Annual numbers of new patients supported by Palliative Care Support TeamIn 2007, Shizuoka Hospital became a regional cancer medical treatment cooperation base hospital. And so, Deputy Director Takeo Maekawa ordered us to develop a palliative care support team as part of the pain clinic. In response to his order, we orga-nized a palliative care support team in 2007. In 2017, we started the palliative care outpatient clinic one day a week, to take care of cancer patients who were discharged from our hospital and referred to us by nearby practitioners. Now, our palliative care support team receives requests, mainly from pallia-tive care certified nurses, to take care of nearly 200 new patients annually (Figure 5).Our anesthesiology department had continued to expand steadily until several years ago, when I experienced the biggest crisis in my life as an anes-thesiologist. Anesthesiologists quit one after another, doubting clinical practice at our anesthesiology department, which was solely involved in too busy surgical anesthesia in the operating room. In those days, the decrease of anesthesiologist was a nation-wide trend, and a few years later, our hospital was involved in this trend. Eventually, I became the only one full time anesthesiologists/specialist working at the hospital. To maintain community medicine, I could not help, in a hurry, asking for help of part-time anesthesiologists. However, even they were not many enough to maintain activities of the operating room. Thus, I by myself had to perform anesthesia for each surgery with help from each surgeon. This experience still is a very