Takeshi Kanno had just 40 minutes.
Moments after Japan's largest earthquake rocked the fishing port of Minamisanriku last March, the 32 year-old doctor and his staff at Shizugawa Public Hospital began evacuating patients to the fifth floor conference room.
There was no electricity. No elevator. No medical supplies on the top floor of the town's only hospital. But with tsunami sirens blaring, Kanno knew he had to rush his patients to higher ground.
There were 107 of them waiting for help. Only 35 were carried to safety.
At 3:26 p.m., a wall of water crashed ashore engulfing four floors of the hospital and flattening the town of nearly 18,000 people.
"My friends, my town, the house I lived in were wiped out in an instant," Kanno says. "Outside the window, I saw patients washed away with their hospital beds. I will never forget what I saw."
Sixty-five of Kanno's patients drowned that day.
Five others died of hypothermia as hospital staff huddled together to keep warm in frigid temperatures, wrapping themselves in thin sheets and lying on cardboard boxes, as they waited for rescue helicopters to arrive.
With roads washed out, debris and mud making streets around Shizugawa impassible, it took three days to evacuate everybody by helicopter. Kanno refused to leave, until the last survivor was pulled to safety.
"I felt so helpless. [As a doctor] I was so frustrated and angry that I couldn't save everybody," Kanno says. "All I could do was sit [next to patients], and watch them take their last breath."
In the aftermath of Japan's disaster, Kanno's heroic efforts drew a worldwide response. His selfless action, hailed as an example of the Japanese spirit, earned him a spot on Time magazine's list of 100 most influential people.
Yet, a year on, Kanno has mixed feelings about how his country has responded to the disaster.
Two months after the quake, he moved 50 miles south to his hometown of Sendai to become a doctor at Tohoku University's Graduate School of Medicine, a decision he made long before the tsunami struck.
The city center has largely returned to normal there.
In Minamisanriku, the concrete shell of Shizugawa hospital is one of few buildings standing now. The mountains of debris that littered the landscape last March have been swept aside, baring nothing but empty lots and concrete outlines of homes that once stood there. Nearly 10 percent of the population has moved away, wary of waiting for the government to decide how and where to rebuild the town.
"The tragedy hasn't ended," he says. "Progress has been so slow. It feels like time has stopped."
Kanno's wife Yukie offers a different perspective. Last March, she spent three agonizing days waiting for her husband in a Sendai hospital, just weeks before their second child was due.
He sent a text message saying he was safe immediately after the quake, but never called after the tsunami. Yukie feared she would have to raise her newborn and 3-year-old daughter Mizuki alone.
"There was no electricity or gas so I told myself, I can't give birth right now," she said." I just tried to stay warm, and protect the life I had inside of me."
Six days later, Yukie gave birth to a healthy boy, with her husband by her side. They named him Rei, or "wisdom" in Japanese, in hopes he would have the wisdom to overcome hardship.
The 11-month old now serves as a constant reminder of that day and the precious nature of life. While Yukie thinks about the destruction she witnessed, she says the focus on her son and daughter has kept her from lingering on it.
"Children grow up so quickly," she says, as Rei attempts to walk, unsuccessfully, behind her. "I can't afford to look back. I have to move ahead."
Takeshi Kanno continues to visit the patients he saved, once a month – not as a doctor, but as a friend, he says. He places flowers by what used to be the hospital entrance, every time.
Thick mud, piles of twisted metal, and broken branches no longer cover the road out front. The sound of excavators organizing the debris echo outside, a sign of progress compared to the cries Kanno heard a year ago.
But he says the lives of his former patients remain largely unchanged. They are still in temporary, prefabricated units with no prospect of rebuilding their homes. Those who lost their jobs to the disasters are still unemployed. The elderly have become weak and sick.
"I want people to know that the battle against the earthquake [and tsunami] isn't over yet," he says. "I hope the world continues to follow our progress."