Reflections on Medicine in Japan

I suppose I should introduce myself before I begin my reflection on my 13 years of teaching medicine in Japan. I am a general internist with 45 years of experience in healthcare, beginning as a nursing assistant in a large psychiatric hospital and nursing homes in the 1960’s. I became very interested in hospitals and, after much work, managed to be accepted to and finish medical school and residency, and complete a masters in public health. Since then I have practiced family medicine, primary care internal medicine, addiction medicine, geriatrics, emergency medicine, preventive medicine and healthcare administration, and for most of my career, hospital medicine. I have also been a student and teacher of communication in healthcare. I first went to Japan in 1962 with my family as a 13 year old, en route to the Philippines where I lived and went to high school. I fell in love with Japan as we travelled to Tokyo, Kyoto, Kamakura, Nikko, and FujiSan. I returned in 1965 as a 1st year college student at International Christian University in Tokyo. Unfortunately I was not a very good student and did not learn Japanese well. I travelled in Japan later in the 1970’s especially in Kyushu. In 2001, after 20 years in medical practice, I responded to a notice in an American medical journal looking for visiting faculty at Chubu Hospital in Okinawa. I visited and taught there in 1–2 week periods for several years. Through Drs. Yasuharu Tokuda and Dr. Seishirou Miyagi, I established relationships with the staff at Fukuoka Miniren, and Dr. Tokuda’s network of colleagues in Mito, Ibaraki-Ken. I met Dr. Toshinori Ozeki from Aichi Miniren in Nagoya in 2006 and since then have been visiting a variety of hospitals in and around Nagoya. Altogether I have visited and taught in about 20 hospitals in Japan, and continue to do so. My reflections are influenced by my long relationship with Japan, my own experiences in healthcare, and by the many wonderful healthcare professionals I have met and worked with in Japan. Of course, my observations reflect my own experiences in healthcare in the US, my travel elsewhere in the world (including medical teaching in South Korea, Singapore and Europe), my political, social and economic values, and my self as a person.