Told he had only three or four years to live, Ichiro Hatanaka decided to reach out to fellow sufferers of amyotrophic lateral sclerosis (ALS) and offer them use of a remodeled ambulance to take short trips.

The free service aims to shine a ray of light into the lives of those with the intractable disorder who might otherwise never venture out.

ALS, also known as Lou Gehrig’s disease, causes muscles in the body to gradually weaken, leading to eventual paralysis.

A resident of Zushi in Kanagawa Prefecture south of Tokyo, Hatanaka, 67, held the inauguration ceremony for his Yume Bus (Dreams on Drive) business in the seaside city on July 19. 

The first user was Hiroshi Matsuyama, a resident of Hiratsuka in the prefecture.

After retiring as an elementary school teacher, Matsuyama, 77, developed ALS in 2009. With his condition steadily worsening, Matsuyama was put on an artificial ventilator nine years ago. He can now only move his facial muscles.

Matsuyama applied for Dreams on Drive to take a trip to Mount Taikanzan in Kanagawa’s scenic Hakone district and enjoy a cup of tea with his wife, Chieko, 76, at a restaurant there that was the site of their first date.

The driver was their eldest daughter, Mami Mitake, 49. A pair of college students joined the party as helpers.

Matsuyama expressed his gratitude in an email he texted himself, using a specialized system that allows for message writing through eye movements.

“I have been rushed to hospital by ambulance several times in emergencies,” Matsuyama wrote in the comment as quoted by his daughter that day. “It is a huge delight to have this reconditioned ambulance available. It’s a dream come true for those like me who have difficulty venturing out.”

Hatanaka recalled that something felt wrong with the calf in his left leg in April 2021 while he was taking a stroll near his home in Zushi. He went for a checkup and was told by the doctor that August he had only “three to four years” to live.

Following his diagnosis, Hatanaka wondered how to make the best use of the time available to him. Helping patients “in the same situation as mine” was a no-brainer.

Hatanaka mounted a crowdfunding campaign and founded the Future of Humanity Institute in the capital’s Marunouchi district.

He spends his days translating and sharing the latest information on ALS therapy and relevant topics from outside Japan. He also rents motorized wheelchairs.

The Dreams on Drive project kicked off in November 2023. The inspiration came when Hatanaka was asked by Osamu Yamaguchi, a mountain guide and longtime friend, whether he “needs an ambulance.”

In accordance with the wishes of his late mother, Kimiko, Yamaguchi, now 67, donated 35 million yen ($230,000) to their home city of Miura, Kanagawa Prefecture, in 2011 to purchase an ambulance.

The one he got had been also used by a private medical center and had 220,000 kilometers on the clock.

Hatanaka realized that a modified ambulance would prove immensely beneficial to ALS patients wanting to take short trips.

“People with an incurable condition such as ALS typically give up on moving about and having fun,” Hatanaka recalled thinking. “The ambulance allows them to board and disembark easily, even in heavy electric wheelchairs. They can also move around and remain comfortable while on artificial ventilators.”

Hatanaka staged a crowdfunding drive to generate cash to renovate the vehicle. The donations totaled 5.4 million yen.

He did away with the red lighting and siren, as well as a monitor and a stand at the back of the vehicle to fix a stretcher. It allowed ALS patients to be transported more comfortably.

An electric lift was added for passengers in motorized wheelchairs to get on and off. The ceiling of the finished vehicle is higher than the one in an ordinary van, making it easier for patients to move around inside.

Up to seven people can ride in the remodeled ambulance. The rear section can hold two people in wheelchairs as well as three additional passengers.

Applicants to Dreams on Drive are asked to submit a write-up following their rides. Their feedback will be used to make improvements to benefit future passengers.

In August, Hatanaka celebrated surviving the four-year deadline he had been given.

“Though I may not have much time left, I still want to create an environment where as many patients as possible can travel across Japan, rather than simply let my dream die,” Hatanaka said.

He is now calling on like-minded people nationwide to introduce similar services, particularly in the southern Kyushu region and the northernmost main island of Hokkaido.