Day by Day, Step by Step

The first day of our laboratory assessment is over, and everything went smoothly. Yet patient safety is never something we can declare finished. There will always be another perspective, another issue, and another opportunity to improve. Perhaps what matters is not eliminating every criticism, but learning to see an outside perspective as advice for making things better. Patient safety, after all, is built not through occasional major efforts, but through small things repeated every day.

The first day of our laboratory assessment by an external organization ended without any major problems.

The assessment of our pathology laboratory also went smoothly, which was a great relief.

Today, there will be a final meeting to review the on-site assessment, so I cannot completely relax until that is over.

When it comes to patient safety, no matter how much we do, there is always more to be done. The work never really ends.

I believe that we already have a solid safety management system in place, and yet the assessors still point out areas where we could do better.

That is only natural. They are looking at our work from a different perspective, and a different assessor might notice something else entirely.

Actually, perhaps “point out” is not quite the right expression.

What they offer is closer to “advice.”

Being told that something has been “pointed out” can sound rather cold, as though one were being criticized for a shortcoming. Thinking of it as “advice” makes it feel quite different.

I myself visit other institutions several times a year as an assessor.

My role there is to interview the physicians who are responsible for managing their departments.

Physicians naturally have a responsibility for patient safety, but many doctors do not fully appreciate this.

Patient safety is not something that should be left entirely to other healthcare professionals.

Physicians, too, must think about how to foster a culture of patient safety throughout the organization and put that thinking into practice, rather than simply leaving the task to others.

I try to convey this during my interviews, but it can be frustrating when the message does not quite get through.

By working to improve patient safety in laboratory medicine, I would also like to think about what I can do to help improve patient safety throughout Japan.

What matters is to keep working at it, steadily, day after day.

And to make that work not something special, but simply part of what we normally do.

Perhaps a good sign of progress would be if, both in this assessment and in future renewal assessments, we could hear the assessors’ comments not as “criticism” of what we are lacking, but as “advice” on how we can make things even better.

Patient safety is built day by day, until working to improve it becomes simply part of what we do.

・・・

external organization — 外部機関。自分の組織とは独立した第三者機関。

on-site assessment — 現地審査。審査員が実際に施設を訪問して行う評価。

point out — 指摘する。問題点や注意すべき点を具体的に示すこと。

shortcoming — 欠点、不十分な点。criticized for a shortcoming で「欠点を責められる」というニュアンス。

assessor — 審査員、評価者。施設やシステムが基準を満たしているかを評価する人。

foster a culture of patient safety — 医療安全の文化を醸成する。foster は「時間をかけて育てる、促進する」。

convey — 伝える。考えや意図、メッセージなどを相手に伝達すること。

day after day — 毎日毎日、来る日も来る日も。継続して同じことに取り組むニュアンス。

#PatientSafety #LaboratoryMedicine #QualityManagement #SafetyCulture #HealthcareQuality #Kamakura #JapanesePathologist

Is It a Part of Healthcare, or the Whole?

After a long holiday spent mostly indoors because of the rain, I am finally back at work. Today also happens to be an important day: the laboratory department for which I am responsible is undergoing an assessment. Thinking about my role in that process has led me to a broader question. In healthcare, each of us has our own specialized task—but how often do we stop to consider where that task fits into the whole?

Back at work after a long break.

It rained for most of the holiday, keeping me indoors, but perhaps that was not such a bad thing after all. At least I had plenty of time to rest.

Still, I wonder how long this seemingly endless stretch of rainy weather will continue.

Severe flooding has caused extensive damage in many parts of southern Kanto.

My heartfelt sympathies go out to everyone affected.

I am a little sleepy this morning, but now that I have started writing my blog, my mind is gradually waking up.

Today, my first day back after the holiday, the laboratory department for which I am responsible is undergoing an assessment, so I am heading to work almost an hour earlier than usual.

Despite being a little out of rhythm after the long break, I managed not to oversleep and safely caught an earlier train.

Although I am officially the person in charge, much of the actual management of laboratory techniques and quality is handled by the medical technologists who perform the tests. For that reason, I had tended to think of my position as largely nominal.

Recently, however, things have begun to change, and those in positions of responsibility are increasingly expected to play a more substantial role.

Risk management, in particular, is something in which we must actively participate.

In other words, all healthcare professionals working in the laboratory must work together to maintain the quality of laboratory testing and improve patient safety.

We can no longer say that doctors need only concern themselves with the patients in front of them.

Or rather, caring for individual patients means taking responsibility for one part of healthcare. Healthcare as a whole does not end there.

Each healthcare professional is expected not only to take responsibility for one part of healthcare, but also to participate in the whole.

What part of healthcare does the work I am doing right now represent?

And where does that part fit into the whole?

Perhaps we need to do our own work while always keeping the bigger picture in view.

This has somehow turned into a rehearsal for my interview during today's assessment.

Still, I would like to approach my daily work with that broader perspective in mind.

We each take responsibility for one part of healthcare—but we must never lose sight of the whole.

・・・

undergo an assessment — 審査・評価を受ける。undergo は検査、治療、審査などを「受ける」という意味。

extensive damage — 甚大な被害。広い範囲に及ぶ大きな被害を表す。

out of rhythm — いつもの調子が戻っていない状態。「連休ボケ」のニュアンスを自然に表現。

nominal — 名目上の、名ばかりの。a largely nominal position で「実質的役割の少ない役職」。

risk management — リスクマネジメント、危機・リスク管理。医療安全や品質管理でも一般的な用語。

medical technologist — 臨床検査技師。国や制度によって medical laboratory scientist などの呼称も使われる。

patient safety — 医療安全、患者安全。

the bigger picture — 全体像、大局。「全体を俯瞰する」という本文の中心的な考えを表す自然な表現。

#Healthcare #PatientSafety #RiskManagement #LaboratoryMedicine #QualityManagement #Kamakura #JapanesePathologist

Ah, Rain Again on the Last Day of the Holiday

 

Four out of the five days of this year’s Silver Week holiday have been rainy around Kamakura. After the torrential rain and flooding two days ago, the rain continues, and so does the concern about the saturated ground. Our plans for Ann’s agility training were canceled, leaving both of us rather bored. Still, perhaps being forced to slow down was exactly what I needed.

In the end, four out of the five days of this year’s Silver Week holiday have been rainy around Kamakura.

Two days ago, we had torrential rain severe enough to cause flooding on the roads.

It is raining again today, and with the ground still saturated, there is still plenty to worry about.

I had been looking forward to taking Ann to her agility training this afternoon, but obviously that is not going to happen.

With my plans suddenly gone, I have not felt like doing much of anything since this morning.

Ann looks bored, too.

I was absentmindedly watching TV programs about the secrets of longevity in Spain and a Major League Baseball game, but then I thought, At this rate, another whole day will be gone before I know it.

So I came to a recently opened coin laundry nearby to wash our shoes.

In fact, I am writing this now while waiting for them to finish.

It is surprisingly convenient.

I checked online to make sure a machine was available before coming here, and then put in two pairs of shoes, one belonging to my wife and the other to me.

Washing and drying together take 35 minutes.

That is not quite enough time to go anywhere else, so here I am, sitting in front of the machine and writing this.

Come to think of it, I spent most of this holiday lounging around at home because of the bad weather.

But perhaps that gave my body a chance to get some much-needed rest.

The Achilles tendon I injured in my right leg is gradually getting better as well.

Today, however, the temperature has dropped considerably from yesterday, and it is almost chilly.

I came out wearing jeans and a long-sleeved sweatshirt.

Perhaps because of the sudden change in temperature, I am not feeling quite as well today, even though I seemed to be recovering yesterday.

The weather is supposed to improve a little tomorrow, but we shall see.

And so, the long holiday that once seemed as though it would last forever comes to an end today.

Tomorrow, it is back to work.

I had planned to get a little work done during the holiday, but in the end, I did absolutely nothing.

Apparently, though, I was more tired than I had realized.

Once in a while, perhaps it is perfectly all right to do nothing and simply relax.

Sometimes doing nothing is exactly the rest we need.

・・・

torrential rain — 豪雨、土砂降り
非常に激しく降る雨。heavy rain よりさらに強い表現。

saturated ground — 水をたっぷり含んだ地面、地盤
雨が続き、これ以上水を吸収しにくくなった状態。

absentmindedly — ぼんやりと、上の空で
特に集中せず、何となく何かをしている様子。

before I know it — あっという間に、気づかないうちに
時間がいつの間にか過ぎる、というときによく使う表現。

much-needed rest — とても必要としていた休息
「実はかなり休養が必要だった」というニュアンス。

once in a while — たまには
Sometimes よりも「普段はしないけれど、ときどきは」という感じ。

#SilverWeek #RainyHoliday #RestAndRelaxation #EverydayLife #FlatCoatedRetriever #Kamakura #JapanesePathologist

Disaster Is Closer Than We Think

The morning after the typhoon, Kamakura was under a clear blue sky. Yet the news showed that flooding had occurred nearby, while landslides elsewhere in Kanagawa had caused even more serious damage. Walking around my neighborhood, I found that the water had already disappeared, leaving little more than the smell of mud behind. It was another reminder that natural disasters are never someone else’s problem.

Yesterday’s typhoon caused flooding in Kamakura, and there have been various reports about the damage since this morning.

Elsewhere in Kanagawa Prefecture, landslides occurred, and rescue operations are reportedly still underway.

Although there were no landslides in Kamakura itself, we still need to remain alert for the next few days.

This morning, the typhoon had passed, leaving a clear blue sky.

I went out for a walk and looked around the neighborhood. The floodwater had completely receded, and all that remained was the smell of mud.

Even so, seeing reports of considerable damage elsewhere made me feel deeply sorry for those affected.

The humidity was high in the morning, probably because of all the water evaporating from the ground, but by early afternoon, a gentle, dry breeze had begun to blow.

Once again, I am reminded of just how frightening natural disasters can be.

Disaster is always closer than we think.

None of us can simply assume, “It won’t happen to me.”

Disaster is never as far away as we would like to believe.

 

・・・

flooding — 浸水、冠水。大雨などで水が土地や道路にあふれること。

landslide — 崖崩れ、土砂崩れ。

rescue operations — 救助活動、救出作業。

remain alert — 引き続き警戒する。alert は「注意を怠らない」という意味。

recede — 水などが引く、後退する。The floodwater had receded. で「冠水した水が引いた」。

those affected — 被害を受けた人々。災害報道などでよく使われる表現。

someone else’s problem — 他人事。「自分には関係のない問題」というニュアンス。

It won’t happen to me. — 「自分だけは大丈夫」「自分には起こらない」という感覚を自然に表す表現。

#NaturalDisaster #Typhoon #Flooding #DisasterPreparedness #AfterTheStorm #Kamakura #JapanesePathologist

I Should Start Thinking About My Healthy Life Expectancy, Too

As I approach my mid-sixties, the idea of “healthy life expectancy” is beginning to feel much more personal. Japan is rapidly becoming an aging society, and I will soon officially join its elderly population. I cannot stop myself from getting older, but I can at least think about how I want to age. For now, my most immediate goal is very simple: lose five kilograms.

A typhoon is approaching, and I have a headache.

According to the noon news, it is a large and powerful typhoon with a central pressure of 960 hPa.

My headache is getting worse, and my joints are aching as well.

Anne also seems listless. I wonder if she is feeling under the weather, too.

Today is Respect for the Aged Day in Japan.

On NHK, cooking expert Remi Hirano blurted out, “Today is Old People’s Day,” and was quickly corrected by the announcer. But she is 79 herself, so perhaps she said it with a touch of self-deprecating humor.

Nearly 30 percent of Japan’s population is now aged 65 or older.

I will soon be 63 myself. In about two years, I too will officially join the ranks of the elderly.

I sometimes wonder what people in their sixties looked like to me when I was a child. But times have changed so much that such comparisons probably do not mean very much.

As someone who will soon be joining the elderly population, one thing I should keep in mind is to stay as healthy as possible and keep the period of my life when I need medical care as short as possible.

For me, extending my healthy life expectancy is more important than anything else.

And to do that, I would first like to lose five kilograms and get myself out of my somewhat metabolic-syndrome-prone state.

The fact that I cannot seem to manage even that is probably my biggest concern at the moment.

Growing older is inevitable, but how I grow older is something I can still work on.

Vocabulary for Learners

healthy life expectancy — 健康寿命。健康上の制限なく生活できる期間。

listless — 元気がない、だるそうな。人にも動物にも使える表現。

feel under the weather — 体調がすぐれない、気分が悪い。口語的な表現。

self-deprecating humor — 自分自身を少しからかうような、自嘲的なユーモア。

join the ranks of ... — 「〜の仲間入りをする」。ややユーモラスにも使える表現。

keep in mind — 心に留めておく、意識しておく。

inevitable — 避けられない、必然的な。

#HealthyAging #HealthyLifeExpectancy #RespectForTheAgedDay #WeightLoss #AgingInJapan #Kamakura #JapanesePathologist

Visiting the Family Grave in Heavy Rain

In Japan, the weeks around the spring and autumn equinoxes are known as Higan, a traditional time for visiting family graves and remembering our ancestors. This year, however, the autumn season seems to have arrived in an unusual way. Endless rain has continued, and now a typhoon is approaching the Kanto region. Despite the heavy rain, I took my mother to visit our family grave today, as we had planned.

I often write on this blog about the Japanese saying, “Neither heat nor cold lasts beyond Higan.”

Usually, Higan arrives, the weather becomes a little cooler, and then the long autumn rains begin. This year, however, the rain seems endless, and now a typhoon has joined in. Before I knew it, autumn seems to have arrived.

We had planned to visit our family grave today during this year’s autumn Higan.

A typhoon is heading straight toward the Kanto region, but we thought we would still be all right today, so I took my mother and managed to complete our visit safely.

It was pouring when I went to pick her up at the station, but fortunately, by the time we arrived at the cemetery, the rain had almost stopped.

At this time of year, the cemetery is usually filled with flowers placed on the graves, but today there were only a few here and there.

It was a rather lonely Higan.

For some reason, I never feel quite settled until I have visited the family grave, so I am glad that we managed to do it again this year.

Tomorrow, I probably will not be able to step outside at all, so I will shut myself in at home.

I suppose I will simply have to stay put.

Incidentally, I looked into why Japanese people visit family graves during Higan.

In Buddhist thought, higan, or “the other shore,” represents the world of enlightenment, while shigan, or “this shore,” represents the world in which we live. Around the spring and autumn equinoxes, the sun rises almost exactly in the east and sets almost exactly in the west. Because the Pure Land of Amida Buddha was believed to lie in the west, this became a time to think of the Western Pure Land and to honor one’s ancestors.

Higan was not originally a Buddhist observance from India but developed as a distinctly Japanese tradition. The spring and autumn equinoxes are regarded as the central days of Higan, with the three days before and the three days after each equinox making a seven-day period.

Even in the pouring rain, visiting the family grave somehow brings a sense of peace.

 

・・・

family grave — 一族・家族のお墓。日本の「○○家之墓」のような墓を表すのに自然な表現。
pouring — 土砂降りの。It was pouring. で「土砂降りだった」。
cemetery — 墓地。grave は個々のお墓、cemetery は墓地全体。
here and there — あちらこちらに、ぽつぽつと。
feel settled — 気持ちが落ち着く。I never feel quite settled until... は「〜するまで何となく落ち着かない」。
stay put — その場にじっとしている、動かずにいる。
equinox — 春分・秋分。spring equinox は春分、autumn equinox は秋分。
the Pure Land — 極楽浄土、浄土。
honor one’s ancestors — 先祖を敬い、供養する。
observance — 宗教的・伝統的な行事、慣習。

#AutumnHigan #GraveVisit #JapaneseTradition #AutumnRain #FamilyMemories #Kamakura #JapanesePathologist

Walking with Anne Again

For most of the day, Kamakura was wrapped in something between mist and drizzle. By evening, however, the rain finally stopped. My right leg seemed to be feeling much better, so I decided to do something I had not done for three weeks: take Anne for a walk. It was only an ordinary evening walk, but after being unable to do it for so long, it felt like a small but welcome return to everyday life.

 

For most of the day, it was somewhere between mist and drizzle, but by evening, it finally stopped.

My right leg seemed to be feeling much better, so I took Anne out for a walk for the first time in quite a while.

It had been three weeks since Anne and I had walked together like this.

As we walked along Wakamiya Oji, I found myself thinking about just how long it had been since our last walk.

After that, we went to a newly opened home improvement store nearby.

They have shopping carts large enough for big dogs, so I put Anne in one and did some shopping.

Perhaps she was a little tired after her first walk in a while, or perhaps she simply liked riding in the cart.

Either way, Anne sat quietly in it the whole time.

After three weeks away, even an ordinary walk together felt a little special.

Vocabulary for Learners

mist — 霧。fog より薄い霧。
drizzle — 霧雨、細かい雨。
for the first time in quite a while — 久しぶりに。会話でも使いやすい表現。
find oneself doing — 気がつくと〜している、思わず〜する。
home improvement store — ホームセンター。日本語の home center は英語では通常このように表現。
either way — どちらにしても、いずれにせよ。
everyday routine — いつもの日常、日々の習慣。

#WalkingWithMyDog #FlatCoatedRetriever #EveningWalk #EverydayLife #LifeWithDogs #Kamakura #JapanesePathologist

 

 

The Benefits of a Cane—and the Guilt That Comes With It

 It has been almost three weeks since I injured my right Achilles tendon while rushing to catch a train at Kamakura Station. The pain has eased, but walking is still not quite normal, and I have started using a cane again. It certainly helps—not only physically, but also by letting people around me know that I have trouble walking. Yet as I recover, I have begun to feel a strange sense of guilt about relying on it.

 

It was September 1 when I suddenly broke into a run at Kamakura Station, trying not to miss the Yokosuka Line, and injured my right Achilles tendon. So it has been almost three weeks now.

Looking back, I suppose I was fortunate that it did not actually rupture, but the damage seems to have been fairly substantial, and I still have some difficulty walking.

For the first few days, there seemed to be some bruising, and the swelling was quite severe.

The pain has eased considerably, but the area is still visibly a little swollen. Running—even just a short jog—is clearly still out of the question. Long walks also seem difficult.

I can stand on tiptoe using both feet, but doing it on my right foot alone is still impossible.

I want to take things slowly and give my leg time to recover, but if I avoid using it too much, I can feel myself losing muscle strength.

Perhaps I should go to the gym and do some machine-based training, but even that feels like too much trouble.

Once people get used to a lower level of activity, they adapt to it remarkably quickly.

I had stopped using my cane for a while, but then I found that walking through stations became difficult again.

I cannot walk briskly. I am slow to begin with, and if I put my foot down at the wrong angle, I suddenly get a sharp pain.

So I have gone back to using the cane.

One of the benefits of a cane is that, in addition to giving physical support, it lets people around you know that you have difficulty walking.

That is, in fact, extremely helpful.

Recently, however, I have become able to walk longer distances without it, and that has brought with it a slight sense of guilt.

If I manage to stand in the right position, I can avoid putting much strain on my Achilles tendon, so I can actually stand on the train without too much trouble.

Even so, when I have a cane, I can sit in a priority seat without hesitation, and I find myself naturally heading toward the part of the train where those seats are located.

Then I start wondering whether there might be someone else who needs that seat more than I do.

I have sometimes thought that if I really want to sit down, I could just take the Green Car or even a taxi.

But I cannot afford to indulge in that kind of luxury every time.

I certainly do not feel like paying close to a thousand yen just for a short train ride.

In the end, if someone comes along who needs the seat more than I do, I can simply give it up.

The more I use a cane, the more I appreciate its benefits. At the same time, I sometimes wonder whether taking advantage of those benefits amounts to abusing them.

Of course, my leg still hurts, and I still walk slowly, so it is not really abuse.

Perhaps I am simply making things harder for myself by thinking of it that way.

I am old enough now that I should probably stop rushing things and make sure the injury heals properly.

Even professional athletes sometimes return before an injury has fully healed, only to make things worse. In some cases, it can even shorten their careers.

And I am not a professional athlete at all.

I am just an ordinary middle-aged guy.

Fortunately, a holiday begins tomorrow, so for a while I will be free from commuting by train.

For now, I think I will rely on my cane as much as I need to and make sure I finally let this injury heal properly.

Sometimes accepting a little help is part of getting better. 

 ・・・

Achilles tendon — アキレス腱

rupture — 断裂する

bruising — 内出血、あざ

swelling — 腫れ

stand on tiptoe — 爪先立ちする

briskly — きびきびと、速足で

priority seat — 優先席

without hesitation — ためらわずに

indulge in — ～という贅沢をする、～にふける

abuse — 悪用する

make things harder for oneself — 自分で自分を苦しめる

shorten one’s career — 選手生命・職業人生を縮める

 

#AchillesTendon #WalkingWithACane #Recovery #GettingOlder #EverydayThoughts #Kamakura #JapanesePathologist

 

Voters at a Loss as Political Parties Keep Changing

Japanese politics has become increasingly difficult for an ordinary voter like me to follow. Parties merge, split, disappear, and reappear under different names, sometimes within a matter of months. There may be perfectly reasonable political calculations behind all this, but from the outside, it can look bewildering. And when the main opposition force repeatedly reorganizes itself while the ruling party remains firmly in place, voters may begin to wonder what choices are actually left to them.

The Constitutional Democratic Party of Japan was dismantled, and a party called the Centrist Reform Alliance was hastily created in its place. It then suffered a crushing defeat in the general election, effectively destroying what had been the main counterweight to the Liberal Democratic Party. And now that party, too, is being dismantled, with yet another new party, the Democratic Reform Group, about to be launched.

The politicians who originally came from Komeito are simply returning to Komeito.

So why can’t the former CDP members simply do the same thing?

I have no idea what negotiations or circumstances led them to establish yet another new party.

Perhaps there are issues involving government subsidies to political parties and other financial arrangements. But since the former Komeito members can return to their old party, I still find the whole thing difficult to understand.

In any case, the CDP dissolved itself just before the general election without having accomplished much as a party, and then suffered what amounted to a self-inflicted defeat.

That cannot simply be explained by saying that Prime Minister Takaichi was popular.

There was once a period when politicians split away from the LDP and repeatedly formed new parties.

Looking back, however, many of those divisions seemed to be driven by politicians insisting on going their own way. Some later returned to the LDP, became cabinet ministers, and appeared perfectly happy about it.

Do such politicians ever think about how voters feel?

Apparently, twenty former CDP lawmakers who survived the general election will join this new Democratic Reform Group.

But with only twenty members, it has already lost much of its numerical influence and may simply become one more small party among many.

Even if the next general election is three or four years away, many of the older politicians who had traditionally been strong at elections suffered major defeats in the last one.

By the time the next election arrives, I wonder how many of them will still have the age and stamina to fight another campaign.

What exactly are the people in this new party thinking?

Meanwhile, as her former rivals continue to weaken themselves, Prime Minister Takaichi is reshuffling her Cabinet today and is even preparing a ministerial post for the Japan Innovation Party.

There are cabinet posts to aspire to if you remain in the LDP. And if you become a minister, perhaps there may be further opportunities beyond that.

People sometimes say that if you are going to buy a lottery ticket, you should buy it from a shop that has produced many winners.

Perhaps politics works in much the same way.

The LDP has governed Japan for most of the postwar era, yet it has failed to halt the declining birthrate, while Japan’s prolonged stagnation continues.

So what exactly are we supposed to expect from it now?

And if there is no longer another party with enough political strength to push through major policies, what are we voters supposed to do?

At the very least, I hope Prime Minister Takaichi will appoint more women to the Cabinet and help improve Japan’s position in the Global Gender Gap Index, where the country currently ranks 117th out of 145 countries.

Incidentally, Japan is often described as ranking last among the Group of Seven advanced economies in this respect.

Which makes me wonder:

Is Japan still really among the leading advanced countries?

When political parties keep changing their names and shapes, voters may eventually lose sight of what they are actually being asked to choose.

・・・

at a loss — どうしたらよいかわからない、お手上げで
Voters are at a loss. のように使います。

counterweight — 対抗勢力、均衡を取る存在
ここでは自民党に対抗できる政治勢力という意味。

self-inflicted defeat — 自ら招いた敗北、自滅
self-inflicted は「自分で自分に負わせた」という意味。

go one’s own way — 我が道を行く、独自路線を取る
政治家や組織の分裂を表す時にも使えます。

numerical influence — 数による影響力
議会政治では議員数そのものが政治的な力になります。

stamina — 持久力、体力
選挙戦を長期間戦う体力という文脈。

aspire to — ～を目指す、～になることを望む
aspire to become a minister なら「大臣を目指す」。

prolonged stagnation — 長期にわたる停滞
経済や社会の低迷についてよく使われる表現。

#JapanesePolitics
#PoliticalParties
#JapaneseSociety
#Democracy
#Voters
#Kamakura
#JapanesePathologist

Japan’s Declining Birthrate, Pediatric Medicine, and Pediatric Pathology

Japan’s declining birthrate is often discussed in terms of how to encourage people to have more children. But supporting children after they are born is just as important. Pediatric medicine, including pediatric pathology, is part of that safety net. A recent visit from a pediatric oncologist from Warsaw reminded me how fragile highly specialized pediatric services can become when case numbers are small and staffing is limited.

 

A manuscript review that I had rather carelessly agreed to take on was withdrawn without my realizing it, just when I had finished putting together about half of my comments.

I suppose I should feel relieved, although part of me also thought that I would have liked to see it through to the end.

Still, when I think about the possibility of having to review the revised manuscript again afterward, I decided that this time I would simply leave it alone.

So the time I had set aside for the review suddenly became available, and things became a little easier.

I had given presentations at academic meetings for two consecutive weeks and was also carrying two manuscript reviews, one of which was the one I had “carelessly accepted.” Recently, I have almost been pushing work through by sheer momentum. But mistakes are not allowed, so it has been quite demanding.

Today and tomorrow I have rather intensive conferences to prepare for, and now I should be able to spend a little more time getting ready for them.

I have also resumed preparations for the academic meeting I will be organizing in February, and yesterday I sent out emails calling for general abstract submissions and took care of several related matters.

Even though I had gained a little extra time, yesterday a pediatric oncologist who had come all the way from Warsaw visited our hospital and also stopped by the pathology department.

I showed her several representative pediatric cancer cases that we have encountered here, while explaining how pathologists work together with oncologists, surgeons, radiologists, and other specialists in our hospital.

Our pathology department is separate from the adult hospital next door, so I work essentially as a pediatric pathologist.

Because obstetrics is located in the adult hospital, I go over there to handle placental pathology, but pathologists from the adult hospital rarely come to our side.

About the only time we consult them is when an adult-type malignant tumor, such as a carcinoma, develops in a child.

At her hospital, however, although the adult and pediatric facilities are separate, there are too few pathologists, so they have to cover both.

Because the number of pediatric cases is also limited, pediatric pathology inevitably tends to receive less attention.

I told her that we hold regular multidisciplinary conferences, and that many surgeons and oncologists personally bring specimens to the pathology department, giving us frequent opportunities to discuss individual cases in detail.

She said that when she returned home, she would try to establish something similar.

I wonder whether my comments were of at least some use to her.

There was also a pediatric pathology meeting recently, and it was clear that pathologists at many institutions are struggling in various ways.

The declining birthrate, together with the decline in obstetric activity, is steadily affecting pediatric medicine.

Pathology is particularly vulnerable because the number of cases is not very large to begin with, and staffing and equipment tend to be given lower priority.

Some people complain that they are told,

“Surely one person is enough?”

I cannot help feeling sorry for them.

I myself joined my current hospital after the previous pathologist had suddenly left, meaning that I arrived at a department with no pathologist at all.

Even during the COVID-19 pandemic, there was still a steady number of sick children, so I remained reasonably busy. In a sense, though, it helped that overall social activity had slowed down.

Now the pandemic is over, and I have managed to find a somewhat younger pathologist to work with me. We currently operate as a two-person team, and I consider myself very fortunate.

If we are going to talk seriously about policies to address the declining birthrate, we need to think not only about encouraging people to have and raise children, but also about maintaining pediatric medicine as one of the safety nets that supports families throughout that process.

Policies should not focus only on increasing the number of children.

Maintaining a healthcare system that properly protects the children who are actually born should also be considered part of any meaningful response to the declining birthrate.

I would like to see pediatric medicine strengthened as a matter of public policy, with greater attention also paid to pediatric pathology, which forms part of its foundation.

Unfortunately, things do not always move in that direction.

Supporting children after they are born should be just as important as encouraging more children to be born.

 

・・・ 

declining birthrate
出生率の低下、少子化。

safety net
困った時に人を支える制度や仕組み。ここでは小児医療を指している。

see something through
始めたことを最後までやり遂げる。

by sheer momentum
勢いだけで何とか進める、というニュアンス。

multidisciplinary conference
複数の診療科・専門職が参加する合同カンファレンス。

receive less attention
十分な関心や優先順位を与えられない。

vulnerable
影響を受けやすい、脆弱な。

give lower priority
優先順位を低くする、後回しにする。

meaningful response
実効性のある対応、本質的な対策。

form part of its foundation
その基盤の一部を成す。

#DecliningBirthrate
#PediatricMedicine
#PediatricPathology
#HealthcarePolicy
#ChildrensHealthcare
#Kamakura
#JapanesePathologist

The AI Threat and Noah’s Ark

 

Warnings about the dangers of AI seem to be growing louder almost by the day. Yet the more I use AI, the more I wonder whether the real danger lies in the machines themselves or in the objectives humans give them. AI does not need hatred, ambition, or even consciousness to produce a disastrous result. Perhaps being extraordinarily faithful to a badly chosen goal would be enough.

Warnings about the threat posed by AI are rapidly growing.

Even some of the people who could be called its creators have begun saying that we may need to slow down the pace of development.

As someone who uses AI regularly, I cannot help being astonished by the remarkable progress it has made in just the past year or two.

But AI itself has not done anything wrong.

Unless we give it a task, it does not simply decide on its own to start doing something.

Turn off the power, and it cannot do anything at all.

So saying that AI will autonomously start doing evil things seems a little too simplistic. Perhaps the real danger is that there are people who will misuse it.

AI works as hard as it can to find an answer to the problem humans give it. Hallucinations hardly seem to discourage it; if necessary, it may even enlist the help of other AI systems in pursuit of an answer.

That, after all, is what it exists to do.

Suppose Country A wanted to destroy Country C and asked:

“What is the most effective way to attack Country C while minimizing our own losses?”

How would AI respond?

Surely there are countless people around the world already giving AI problems of this sort. AI systems may even be asking other AI systems for help in finding answers.

Today’s AI has safeguards.

But those safeguards are not the conscience of AI itself. They are safeguards installed by humans.

What are we to do about human beings who think such foolish things?

Then again, looking back over human history, people like that have never disappeared, so perhaps there is nothing surprising about it.

Suppose we gave AI only one instruction:

“Make the global environment as good as possible.”

And suppose we forgot to add the condition that human life and human happiness must also be protected.

Then it would not be logically absurd for AI to arrive at the answer:

“In that case, perhaps it would be better if there were no humans.”

It might eventually conclude that removing human beings from the Earth would be the best thing for the planet.

All humans would disappear. Energy supplies would eventually cease. AI itself would stop functioning.

Only the other animals would remain on Earth, and they all lived happily ever after.

In the story of Noah’s Ark in the Old Testament, a righteous man survives together with the animals.

But Noah’s descendants seem to have provided ample evidence that truly righteous human beings are rather difficult to come by.

Perhaps next time, human beings alone will be erased.

Given enough time, some intelligent life-form might evolve from the surviving animals and eventually learn to operate AI again.

But surely it would be a completely different species from present-day humanity.

Then again, if animals survive and eventually evolve into intelligent beings, perhaps we will simply end up in the same place all over again.

Maybe what we should fear is not that AI will develop malice, but that it will be far too faithful to the objectives humans give it.

The other day, I asked AI:

“Please develop a way to extract oxygen from CO₂ and prevent global warming.”

It cheerfully replied that it could not actually develop such a technology itself, but that it could certainly help humans work on it.

Perhaps I had expected a little too much.

Still, for a moment, it seemed almost as though AI had something resembling a conscience.

And I was rather pleased.

Perhaps the real question is not whether AI will become more human, but whether humans can remain humane enough to use it wisely.

・・・

pose a threat — 脅威となる、危険をもたらす
“the threat posed by AI” で「AIがもたらす脅威」。

pace of development — 開発の速度
技術開発や研究の進む速さを表す自然な表現。

misuse — 悪用する
本来の目的とは異なる危険な使い方をすること。

safeguard — 安全装置、予防措置
事故や悪用を防ぐための仕組み。

conscience — 良心
善悪を判断し、自分の行為を律する心。

logically absurd — 論理的に不合理な
“not logically absurd” で「論理上はおかしくない」。

arrive at an answer — 答え・結論に到達する
思考や分析の結果として結論を得る表現。

ample evidence — 十分すぎるほどの証拠
やや皮肉を込めて使うこともできる表現。

malice — 悪意
人を害そうとする意図。evil より「意図としての悪意」に近い語。

humane — 人間味のある、人道的な
human（人間の）とは異なり、思いやりや人間性を含む言葉。

 

#ArtificialIntelligence #AIRisk #AIandHumanity #NoahsArk #FutureOfAI #Kamakura #JapanesePathologist