تدريب Shadowing: The Killer Nurse Who Poisoned Patients | Ayumi Kuboki Case - تعلم التحدث بالإنجليزية مع YouTube
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Between early July and late September 2016, 48 patients died at Oguchi Hospital in Yokohama, Japan.
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Between early July and late September 2016, 48 patients died at Oguchi Hospital in Yokohama, Japan.
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For a long-term care ward, that's not necessarily alarming.
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There are plenty of elderly and terminally ill patients receiving care there.
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But 48 in around three months, including five in a single day in late August and four in a single day in early September,
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was enough to make some of the staff uneasy.
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But it wasn't enough to call the police.
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Not yet.
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However, it would turn out that not all of these deaths were of natural causes.
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Some of the patients were given a helping hand.
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What finally broke the case open wasn't a tip-off.
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It wasn't a confession.
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It wasn't even a body.
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It was actually a completely accidental discovery.
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This is the case of the Oguchi Hospital murders.
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September 20th, 2016, a nurse on the fourth floor of Oguchi Hospital was tending to a patient whose condition was rapidly deteriorating
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when she noticed that the liquid in his IV bag was half empty, but also foaming off.
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That shouldn't happen.
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The IV solution in question never creates foam.
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She brought it to the doctors.
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They examined it and found the solution had been contaminated with diametol, a disinfectant used throughout the hospital.
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It wasn't a small amount, it was enough to kill.
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This was serious.
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They checked every IV bag on the ward.
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Several others had been pierced through their protective filters with a fine needle, small enough that the hole was almost invisible,
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but large enough to inject disinfectant into the drip.
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The patient who had already received half of the contents of the poisoned drip bag, Nobuo Yamaki, 88 years old, died that same day.
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His 88-year-old roommate, Soso Nishikawa, had died two days earlier.
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Autopsies were performed on both men.
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Both men had traces of disinfectant in their bodies.
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They had been poisoned.
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But who had done this?
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Before we dive into that, you need to understand what was already happening on that ward before the deaths.
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The fourth floor of Oguchi Hospital had been a difficult place to work for some time.
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Nurses were clashing with each other.
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There were complaints of gossiping, arguments over patient care, and instances of staff yelling at patients in front of their families.
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Multiple nurses had resigned over accusations of verbal abuse and neglect.
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The ward had a reputation for having an internal tension that management hadn't resolved.
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Then, starting a few months before the first confirmed murder, a series of strange incidents occurred on the ward.
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Patient records went missing, nurses' uniforms were found torn, items were being stabbed with needles,
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drinks left at the nursing station were spiked with foreign substances, and nobody knew who was behind it.
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The harassment was never resolved.
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It escalated.
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What no one realized at the time was that by July, the poisoning of the IV bags had started.
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In the months before the poisoned IV bags were discovered, the Yokohama City Council had received a series of complaints about these incidents at Oguchi Hospital.
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The city did not investigate them in detail.
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After it was found that patients had been killed, the city set up a third-party verification committee to figure out why.
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The committee's conclusion, delivered in March 2017, was striking.
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Under Japan's Medical Care Act, the hospital had no obligation to report any of this to the city.
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The city had no authority to inspect or instruct the hospital.
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The complaints had into a gap in the system.
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The hospital director admitted he initially believed the problems could be handled internally.
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By the time he contacted the police, three people were already dead.
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The police were called on the same day that the poison ivy bags were discovered.
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What followed was nearly two years of painstaking detective work.
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It was incredibly difficult to discern who was guilty.
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The core problem was the disinfectant.
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It was used all over the hospital and everyone had access to it, so this alone didn't help narrow down the suspect pool at all.
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And the bodies, most of them, were already gone.
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Japan has one of the world's highest cremation rates and families often move quickly from death to cremation.
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Of the 48 deaths that occurred that summer, many of the bodies had been cremated before anyone knew that there was a problem to investigate.
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The police acknowledged publicly
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that they might never be able to establish the cause of every suspicious death that occurred on the ward.
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But still, the investigators went through everything they could.
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They took the hospital's entire disinfectant inventory.
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They analyzed the uniforms of every nurse who had worked on that ward.
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Only one uniform came back positive for traces of the disinfectant that had been used to poison the patients.
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It belonged to a nurse named Ayumi Kuboki, and it was concentrated around her pocket.
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The evidence was weak, very weak, but it was something.
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Then came the camera footage.
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On the nights immediately after the tampered backs were discovered, the police installed security cameras throughout the ward.
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Footage from those cameras showed Kuboki walking through the hospital during a night shift, carrying a drug she had not been assigned to administer.
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She was moving through areas she had no reason to be in.
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And then one of her colleagues came forward with information.
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He told the police he had personally witnessed Kubo-ki enter the room of a patient she wasn't assigned to.
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Within minutes of her leaving, the patient's condition sharply deteriorated, and ultimately, the patient died.
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None of this was enough.
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The disinfectant was everywhere.
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Suspicious behavior wasn't proof.
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The colleague's account was circumstantial.
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Kuboki had quit Oguchi and moved on to a job at a care facility in Kanagawa.
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She had denied any involvement with the killings to every reporter who reached her.
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By late June 2018, almost two years after the deaths, the Kanagawa Prefectural Police decided they had gone as far as the physical evidence would take them.
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They brought her in for voluntary questioning.
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Kuboki, who had spent two years denying everything, broke.
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She confessed to injecting diametrol into the IV bags of at least 20 patients.
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She was arrested on July 7th,
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2018, on suspicion of Sozo Nishikawa's murder and re-arrested over the following weeks for the murders of Nobuo Yamaki and Asai Okitsu.
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But who was Ayumi Kuboki and what drove her to kill so many people?
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Ayumi Kuboki was born in 1987 and grew up in Ibaraki Prefecture.
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She qualified as a nurse in 2008 and worked at another hospital before joining Oguchi in 2015.
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Her early career was difficult in specific ways.
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She was competent at routine work, but struggled when situations required quick improvisation.
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She kicked a hole in her dormitory wall as a result of stress.
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She was rotated through wards, rehabilitation, disabled care, and eventually an affiliated elder care facility,
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where a patient died during her shift and she watched a colleague get shouted at by the grieving family.
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By 2014, she was in psychiatric care for depression, overdosing on sleeping pills and taking leaves of absence.
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But it seems that she was able to keep her mental health struggles hidden from her peers.
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One former co-worker said she was considered competent, but she was the kind of person who was hard to figure out.
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You never really knew what she was thinking.
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After she moved to Oguchi, she also largely flew under the radar.
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She showed up, she did her job.
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She didn't seem to cause any problems at all.
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But on the inside, she was unhappy.
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In June 2016, three months before the first confirmed murder, Kuboki called her mother from the hospital.
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She told her about the slashed aprons, the missing charts.
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She said, it's scary, maybe I should quit.
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Her mother initially agreed.
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Then she said, wait until you get your bonus, then quit.
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Kuboki stayed and that decision would leave at least three people dead.
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Kuboki found something about her job unbearable.
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That something, it turned out, was a specific part of what nurses on that ward were expected to do.
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When a patient died during a nurse's shift,
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it was that nurse's responsibility to sit down with a family to break the news and to be present for their grief.
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Kuboki found this troublesome.
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That's the word she used when police asked her about it.
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Troublesome.
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She told investigators, I hated seeing the rapid deterioration in their condition.
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I did not want them to die during my shift.
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It was troublesome and difficult to explain to their family members.
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So she found a way to make sure she never had to.
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What Kupuki did was draw diametrol into a syringe, then use a fine needle to pierce the protective filter on a patient's IV bag,
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the rubber-sealed stopper designed to keep the fluid sterile and inject the poison into the bag.
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The patient then received it slowly through their IV line, along with whatever medication they were supposed to be receiving.
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The timing was deliberate.
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She told police she administered the disinfectant between 3pm and 4.55pm,
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the shift changeover period when nurses were occupied with handover briefings.
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Her colleagues were busy, and so nobody was watching.
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In the case of Sozo Nishikawa, she is believed to have poisoned his drip when she arrived early for a scheduled night shift.
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He was confirmed dead at 7pm, so the day nurse, not Kuboki, was the one working.
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The day nurse broke the news to his family.
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That was Kuboki's logic, to poison them on her time, let them die on someone else's.
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She told investigators she targeted patients she believed were already near death, patients who she thought would die during her shift anyway.
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Ayumi Kuboki was arrested on July 7th, 2018.
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She was 31 years old.
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After her arrest, she gave interviews to multiple TV stations and newspapers.
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And then, while in custody, she sent handwritten letters to media outlets denying everything.
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She said she was shocked by the crimes.
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She expressed sympathy for the victims and their families.
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She claimed she hadn't noticed anything unusual during her shifts.
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And she called the murders heinous.
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She had confessed her guilt to the police, but outwardly, she played the role of an innocent woman.
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Eventually, she retracted the statements she'd made in the letters.
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She admitted that the confessions she'd made were true.
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Her motive, she said, was exactly what she had first told investigators.
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She didn't want to be on shift when patients died.
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She found explaining deaths to families troublesome.
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But psychiatrist Tamami Katada, who analyzed Koboki's psychology, suggested the motive may have run deeper than an aversion to inconvenience.
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Katada's view was that Koboki's real target was not the patients, but her colleagues and supervisors.
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By engineering patient deaths to fall on other nurses' shifts,
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she could create a series of unexplained deaths that would trigger scandal and bring those around her down.
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The patients, according to that theory, were merely instruments to be used against others.
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Three deaths were confirmed in court.
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Asai Okitsu, 78 years old.
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Koboki contaminated her IV bag on September 15th.
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Okitsu's condition collapsed the following morning, and she died on September 16th, 2016.
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Unlike Kuboki's assertion that she was just targeting terminally ill patients, Okitsu was an orthopedic patient with an infected wound.
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She was not terminally ill.
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She was just someone who tried to leave the hospital early.
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And Kuboki, worried that Okitsu would injure herself and she would receive the blame, decided that Okitsu would have to be poisoned too.
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Sozo Nishikawa, 88 years old.
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He died on September 18, 2016, in the terminal care ward at Ouchi Hospital.
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Police believe he was poisoned between 3 p.m and 4.55 p.m that day, when the disinfectant entered his drip.
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He was dead by 7 p.m., one of the day nurses told his family.
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Nobuo Yamaki, 88 years old.
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He shared a room with Nishikawa.
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He died on September 20th, the same day the foaming IV bag was discovered.
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The same day staff on the ward checked every bag.
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The same day the hospital called the police.
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There was a fourth case that investigators believe she was responsible for.
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An 89-year-old man, whose name has not been publicly disclosed, had also had his IV bag contaminated.
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Kanagawa Prefectural Police referred to a fourth murder charge to prosecutors.
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Prosecutors declined to indict, citing insufficient evidence.
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The prosecution's theory was that Kuboki had intended to poison a different patient sharing the same room
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and that the 89-year-old man's bag was contaminated by mistake.
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So Kuboki had been trying to poison someone else in the same room and the wrong bag was pierced.
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Beyond the three confirmed victims, Kuboki admitted to targeting around 20 patients Police suspected she may
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have been responsible for many of the 48 deaths from that summer.
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But with most of the bodies having been cremated and the forensic evidence gone, the full number will likely never be known.
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Kuboki was formally indicted on December 7th, 2018.
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The Yokohama District Prosecutor's Office charged her with three counts of murder for Okitsu, Nishikawa, and Yamaki,
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and five additional counts of preparation for murder relating to five more IV bags she had already contaminated with diametol,
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but which had not been yet administered to patients.
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Investigators had found those bags during the September 20 ward wide check, the same day Yamaki died.
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Eight counts in total.
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Her trial opened on October 1st, 2021, before the Yokohama District Court, more than five years after the murders.
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At the start of the trial, she pleaded guilty.
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She apologized to the families of the victims.
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She told the court she had been mentally and physically exhausted from nursing, that she had felt she had no choice
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but to accelerate the deaths of the patients in order to temporarily relieve her own anxiety.
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In her final statement, she said she wanted to make amends with her own death.
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The prosecution argued for the death penalty.
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They said she had acted with full awareness, with calculation, and had done so repeatedly.
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The court found the truth was more complicated.
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Kuboki had been assessed during a three-month psychiatric evaluation after her arrest.
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The evaluation found she showed traits consistent with autism spectrum disorder.
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And that was acknowledged as a mitigating factor.
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But she had also been diagnosed with schizophrenia.
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But the court rejected the schizophrenia defense entirely.
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It was determined that she had known what she was doing.
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She had done it on purpose, repeatedly over time.
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She was legally sane.
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On November 9th, 2021, presiding judge Kazunori Karei sentenced her to life imprisonment.
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He stopped short of the death penalty because of the remorse she had shown during the trial.
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He said she understood the gravity of what she had done.
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His reasoning was that it would allow her to face the weight of her guilt for the rest of her life
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and give her the chance to find the right path again.
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The son of Nobu Yamaki responded through his lawyer.
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He said it was strange that she wasn't sentenced to death for killing innocent people due to such selfish motives.
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Neither the prosecution nor the defense was satisfied with the verdict, so both sides appealed.
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The case went to the Tokyo High Court, which upheld the life sentence.
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The ruling stands.
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Kuboki is currently in prison.
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Though the possibility of parole is not completely out of the question, she will most likely spend the rest of her life there.
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Oguchi Hospital no longer exists by that name.
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It was renamed Yokohama Hajime Hospital.
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A new name, the same building.
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And Japan is still sitting with a wider problem that this case brought to the surface.
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It has one of the fastest staging populations in the world, and one of the most severe nursing shortages.
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Hospitals are understaffed, nurses are overworked, and each is handling more than one person should handle alone.
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That doesn't explain or excuse what Kuboki did, but it does explain how someone who was falling apart could
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fall off the deep end without anyone noticing until a dropped bag hit the floor and started to phone.
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What makes this case so difficult to understand isn't the scale of the problem, it isn't the method, it's the frivolity of the motive.
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Asai Okitsu, Sozo Nishikawa, Nobuo Yamaki, possibly more.
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They died because a nurse wanted to avoid some difficult conversations, because she found grief, other people's grief, inconvenient.
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The judge wanted her to live with the weight of that.
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Whether it actually weighs on her, whether any of it is real to her is something only she knows,
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but hopefully her imprisonment brings some solace to some of the bereaved families.
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Let me know your thoughts in the comments and I will see you in the next one.
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Thanks for watching.
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في هذا القسم، سوف تتعلم كيفية تحسين مهاراتك في التحدث باللغة الإنجليزية من خلال التمرين على نص فيديو مثير يتعلق بحالة أغوكي التي شهدت جرائم قتل في مستشفى أوغوكي. هذا الدرس سيشمل مجموعة من المفردات والعبارات الأساسية التي يمكن أن تساعدك في فهم وتحليل الحالات الصعبة والطبية. من خلال الاستماع إلى ما يقال ومتابعة النطق، يمكنك تعزيز طلاقتك وثقتك في استخدام اللغة الإنجليزية.
المفردات والعبارات الرئيسية
- مريض (Patient)
- قتل (Murder)
- مستشفى (Hospital)
- سم (Poison)
- تحقيق (Investigation)
- موظف (Staff)
- أعراض (Symptoms)
- حالة خطيرة (Critical condition)
نصائح للممارسة
لتحسين مهاراتك في التحدث، استخدم طريقة التظليل في الإنجليزية أثناء مشاهدة الفيديو. حاول تقليد النطق وتحديد السرعة المستخدمة في الفيديو، والتي يمكن أن تكون سريعة في بعض الأحيان. إليك بعض النصائح المفيدة:
- استمع إلى الجمل بشكل متكرر وحاول تكرار كل جملة بعد سماعها.
- ركز على نبرة الصوت والإيقاع المناسبين أثناء المحادثة.
- استخدم shadowspeaks كأداة لمساعدتك في تطوير مهاراتك في النطق.
- تناول الموضوعات الهامة وكن على دراية بالسياق لتسهيل الفهم أثناء المحادثة.
- شارك في shadow speech مع أصدقائك أو عبر الشبكات الاجتماعية لتحسين مهاراتك.
باتباع هذه النصائح، ستتمكن من تعزيز مهاراتك اللغوية وتقديم نفسك بشكل أفضل عند التحدث باللغة الإنجليزية. إذا كنت ترغب في تطبيق ما تعلمته، يمكنك البحث عن مقاطع فيديو مماثلة على تعلم الإنجليزية مع يوتيوب والانخراط في هذا الأسلوب التعليمي الممتع والمفيد!
ما هي تقنية التظليل الصوتي؟
التظليل الصوتي (Shadowing) تقنية تعلم لغة مدعومة علمياً، طُورت أصلاً لتدريب المترجمين الفوريين المحترفين. الطريقة بسيطة لكنها قوية: تستمع لصوت إنجليزي أصلي وتكرره فوراً بصوت عالٍ — كظل يتبع المتحدث بتأخير 1-2 ثانية. تُظهر الأبحاث تحسناً كبيراً في دقة النطق والتنغيم والإيقاع وربط الأصوات والاستماع والطلاقة.
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