Every morning at 9:30 a.m., Ivy goes to work at the Tokyo Metropolitan Children’s Medical Center in Fuchu in western Tokyo.

The Labrador retriever is an indispensable member of the medical staff there, serving as a “facility dog.”

For Mei Kotake, 11, Ivy means the world. 

On the night of Oct. 21, 2022, Mei, who had developed acute lymphocytic leukemia, was urgently hospitalized.

Four days later, Ivy visited her hospital room.

Mei liked Ivy’s black eyes and glossy fur.

“Cute!” she exclaimed.

From that moment on, the dog became an irreplaceable part of Mei’s life.

Ivy came to see Mei several times a week. When she was feeling well, she played with origami toys alongside Ivy and hugged the canine. 

Sometimes Mei played tricks on Ivy. She hid treats under a handkerchief or blew in the dog’s ear.

But no matter what mischief Mei got up to, Ivy always seemed to take it easy, as if to say, “It can’t be helped.”

When Mei was in bed with a stomachache from the side effects of chemotherapy, Ivy rested its head on her stomach.

When Mei was lying limp from an intravenous drip, Ivy would snuggle up to the girl and sleep pressed against her back.

“Whenever Ivy visited, it was like, ‘Happy time has come!’” Mei said. “Because Ivy was there, I was able to do my best in the hospital.”

After about 10 months in the hospital, Mei was discharged in August 2023.

Her father, Toru, 49, said, “When we visited (my daughter) on the days Ivy had been there, she would report with great happiness that ‘Ivy came today.’ When we left, Mei sometimes looked lonely, but we felt relief knowing, ‘Ivy is here for her.’”

A VERY SPECIAL JOB

Dogs that work in specific facilities, such as hospitals and special-needs classes, are called facility dogs.

The Tokyo Metropolitan Children’s Medical Center welcomed Ivy in 2019.

Each facility dog is paired with a special handler.

Mayuko Ohashi is Ivy's handler. After working as a nurse for 16 years, Ohashi received specialized training to become a handler.

Ivy and Ohashi live together. Every morning, they go for a walk, brush their teeth and get ready before heading to the hospital five days a week.

Ivy’s work is diverse. The Labrador retriever plays with children, helps their rehabilitation, comforts patients during bone marrow biopsies and other painful tests, and even accompanies them to the operating room.

Sometimes, Ivy stays at patients’ bedsides alongside their families to see the patient through their final days.

“Ivy is great at being in sync with the children’s emotions,” Ohashi said.

When a normally playful child becomes scared before getting a shot, Ivy watches the child’s face intently.

The dog can sense that this is not the time to play and stays very still, even though Ohashi has not trained Ivy to do that.

Ivy sometimes rides on the stretcher with patients to the operating room.

Seeing this, the nurses relax and their tense expressions soften.

Ivy’s presence is said to have a positive impact not only on the medical staff, but also on the children undergoing surgery.

“Ivy is trained not to move. Just by being there, Ivy makes the atmosphere feel different from a hospital,” Ohashi said.

EXPERT TRAINING

According to “Shine On! Kids,” a nonprofit organization that promotes facility dogs, these canines have been introduced mainly in the United States since around 2000, and there are currently more than 2,000 in use worldwide.

In Japan, a golden retriever named Bailey was first introduced to Shizuoka Children’s Hospital in 2010. The Kanagawa Children’s Medical Center followed in 2012, the Tokyo Metropolitan Children’s Medical Center in 2019, and the National Center for Child Health and Development in 2021.

To become a facility dog, dogs begin rigorous training at around 2 months old that continues for approximately two years.

They must become accustomed to common distractions in hospital environments, including people in white coats and alarms, and learn nearly 100 commands such as “sit,” “down,” and “lie down with (patients).”

In the past, the training was outsourced to an organization in the United States but since 2019, facility dogs can be trained domestically.

Shine On! Kids and the Shizuoka Children’s Hospital conducted a survey of approximately 600 health care professionals at the hospital.

According to the survey, respondents felt that facility dogs were most effective in palliative care at the end of life. 

Natsuko Murata of Shine On! Kids, who was in charge of the survey, said unlike therapy dogs that visit various facilities, facility dogs can establish a relationship with patients from the early stages of hospitalization.

"In the comments section of the survey, their responses saying, ‘The moment a facility dog enters the room, the atmosphere changes,’” Murata said. "I think it can also give warmth to the families of patients who are going through a difficult time without aggressive treatment.”

BOUNDING FORWARD

Shine On! Kids has received inquiries from dozens of hospitals interested in utilizing facility dogs.

The organization is currently in communication with eight hospitals.

One obstacle, however, is the cost.

Each facility dog costs about 10 million yen ($67,200) a year for food and handler labor.

In the first year, training costs are also added, totaling about 20 million yen.

Initially, Shine On! Kids covered all training and personnel costs. In recent years, hospitals have begun to cover some of these costs as well.

However, since the program is not covered by the reimbursement system, all hospitals are having a difficult coming up with the funds.

Despite the high costs, an increasing number of hospitals have recently begun to consider introducing the program.

The Tokyo Metropolitan Children’s Medical Center is conducting a crowdfunding campaign until March 14 for the introduction of a second facility dog.

Ivy is currently only working with patients who are hospitalized for long periods of time for physical illnesses such as childhood cancer.

The center, however, hopes to have a facility dog to support children who are hospitalized for mental illnesses such as depression and eating disorders, too.

Crowdfunding has already raised the first target amount needed for the introduction of the new dog.

The plan is to welcome the second dog in the summer of 2026.

Shine On! Kids hopes that facility dogs will be covered by insurance in the future and that they will become a requirement for pediatric cancer base hospitals.

The organization hopes to increase the use of facility dogs, collect data and lobby the government.

Mei visited the Tokyo Metropolitan Children’s Medical Center in late February, the first time in about a month, for an examination.

When Mei found Ivy, she ran up to the Labrador retriever, shouting, “Ivy!” and hugged the dog’s fluffy body tightly.

With her cheeks flushed, Mei said, “I want to be a handler in the future.”