Needling the liver: Time of Young Lion

I came across a copy of an essay written by Professor Tadayoshi Takemoto (Emeritus Professor at the Institute of Gastroenterology, Tokyo Women’s Medical University [TWMU]) that describes the study of endoscopy in the Institute. In that essay he mentions my struggle to develop percutaneous transhepatic cholangio-drainage (PTCD, or percutaneous transhepatic biliary drainage [PTBD]) for treatment of obstructive jaundice when I was a resident doctor. At that time, we did not have endoscopic retrograde cholangiopancreatography (ERCP), not to mention sonography, computed tomography (CT), or magnetic resonance imagine (MRI); it was difficult to diagnose or treat jaundice. The essay is a description of a young doctor struggling in clinical studies, written from the viewpoint of Professor Takemoto as an outside observer. At that time, I was a resident surgical doctor at the Institute of Gastroenterology, Tokyo Women’s Medical University established by Professor Komei Nakayama (who passed away in 2005); Professor Takemoto was a professor and chairman of the Department of Gastroenterology and also chief of the Gastroenterological Endoscopy Department. Professor Takemoto has no experience of having worked together with me but wrote about my efforts through his great insight. The essay is titled ldNeedling the Liver,” contained in a section called “Children of Endoscopy,” published by Professor Takemoto. Professor Takemoto specialized in endoscopy while my research was conducted by X-ray apparatus. I have no idea why Professor Takemoto chose my research as a topic, since it had little to do with his specialty. At any rate, my efforts and struggles were depicted through the eyes of Professor Takemoto. I was then in my third year as a resident doctor. I make this paper public with a view to encouraging young doctors to take up the torch during those times when great efforts in clinical studies are needed.