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A manuscript review that I had rather carelessly agreed to take on was withdrawn without my realizing it, just when I had finished putting together about half of my comments.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

A New Week Begins Under a Blue Sky

A clear blue sky has finally returned. After yesterday’s rainy dog show, Mount Fuji is visible again from the train window, making me wish the weather had arrived just one day earlier. My body, however, is still feeling the effects of the weekend. From sore muscles to world affairs, Okinawa politics, Ukraine, Gaza, and even sumo, this Monday morning brings together all sorts of thoughts as another week begins.

A blue sky has spread across the morning.

It is a little muggy, but Mount Fuji is visible from the train window. Yesterday, even though I was right at its foot for the dog show, I could not see so much as its lower slopes.

I cannot help thinking how nice it would have been if this weather had arrived just one day earlier.

Still, perhaps those of us who took part in the competition in the rain developed a certain sense of camaraderie.

I suppose I was tired.

I slept for more than seven hours, which is unusual for me, and yet I still feel as though I could use more sleep.

On top of that, my right ankle has worsened again, and now my lower back hurts as well.

All I did was move back and forth inside a square a little over ten meters across and jog around it a few times. But for someone like me, who normally strolls along at a leisurely pace, it seems to have been a greater physical burden than I expected. Now I have sore muscles here and there.

Once my foot recovers, I should probably add a little jogging to my walks with Anne, and start doing some simple stretching every day.

Yesterday, in the Okinawa gubernatorial election, a newcomer and former Ministry of Internal Affairs and Communications official defeated the incumbent, who had served two terms over eight years, and became the new governor.

He is from Naha and, as it happens, a University of Tokyo graduate.

He seems very sincere and refreshingly new to the role. I hope he will settle in for the long haul and work steadily to raise prefectural income and address poverty.

The new governor also supports the relocation of the U.S. Marine Corps base to Henoko.

Perhaps this will finally allow the long-running base issue to move forward significantly.

I am not an Okinawan resident, so I do not think I am in a position to say too much. Still, as a resident of Kanagawa Prefecture—which ranks third after Okinawa and Aomori in the presence of U.S. military facilities—I have various thoughts about the issue.

But the problem is simply too complicated, especially now that it is intertwined with the rapidly changing global military situation, so I will leave it there.

In Ukraine, it was reported that a passenger train was struck by a Russian drone shortly after a train carrying foreign dignitaries had passed nearby.

Russia seems to me to be a country where almost anything goes.

The situation between the United States and Iran remains at a standstill.

I have also noticed that I see far fewer reports about Gaza these days.

I wonder what is happening there now.

Today is a newspaper holiday in Japan, so there was no morning paper.

Wondering how the Grand Sumo Tournament had gone, I checked online and found that the top-ranked wrestlers had come through safely.

That was a small relief.

Now then, time to get on with another week.

A blue sky does not solve everything, but it is still a good way to begin a new week.

・・・

• lower slopes — 山の裾野。山の低い部分。

• camaraderie — 仲間意識、連帯感。同じ経験を共有した人同士に生まれる親近感。

• at a leisurely pace — のんびりしたペースで。「ちんたら歩く」を自然な英語にした表現。

• settle in for the long haul — 腰を据えて長期的に取り組む。

• at a standstill — 膠着状態で、進展がない状態。

• come through safely — 無事に切り抜ける。ここでは上位力士が順当に勝った、という意味。

#BlueSky #MondayMorning #EverydayThoughts #WorldAffairs #Sumo #Kamakura #JapanesePathologist

Today, I Made My Debut

I got up at four this morning for a rather unusual reason: Anne, our Flat-Coated Retriever, was entering a dog show near Mount Fuji. She had been in the ring twice before, but this time there was one important difference. I was going to hold the lead myself. With nothing more than a little studying from a handbook, I was about to make my debut as a dog-show handler.

Up at four this morning.

Why?

Because Anne, our Flat-Coated Retriever, was entering a dog show.

I had come home late last night after a reunion of my old pathology department, so I could easily have complained about the early start. Instead, I kept my complaints to myself and did my best to head for the venue at the foot of Mount Fuji.

 

And today, I made my debut as a handler.

At a dog show, pedigree dogs registered with the JKC—the Japan Kennel Club—are presented to judges.

The judges evaluate such things as appearance, body structure, movement, and how well each dog represents the characteristics of its breed.

The person holding the dog's lead in the ring is called the handler.

Anne had already appeared in two dog shows, but this was my first time handling her myself.

I had done nothing more than study a handbook, but because this was a relatively small show, Anne's breeder and an experienced acquaintance encouraged me to take the lead myself.

Straight into the deep end.

There were not many female Flat-Coated Retrievers entered, which certainly helped, but somehow, working together as one man-and-dog team, we managed not to get disqualified—and even came away with an award.

 

A handler has to run with the dog and then position her so that she stands properly for the judge.

And, unfortunately, it was raining today.

My foot, which had finally been getting better, naturally became worse again.

It looks as though I may have to start using my walking stick again tomorrow.

Anne came home with an award. I came home with a sore foot.

・・・

handler — ドッグショーなどで犬を引き、審査員の前で見せる人。
pedigree dog — 血統書付きの犬。
body structure — 体格、骨格、体のつくり。
represent the characteristics of its breed — その犬種らしい特徴を備えている。
straight into the deep end — 十分な経験がないまま、いきなり本番に挑むこと。
come away with an award — 最終的に賞をもらって帰る。
walking stick — 杖。米語では cane もよく使われる。

#DogShow #FlatCoatedRetriever #DogHandler #LifeWithDogs #MountFuji #Kamakura #JapanesePathologist

Why Celebrity Obituaries Seem More Common in a More Diverse Society

It has been raining again since early this morning, and I am beginning to wonder how long this weather will continue.

After finally getting through yesterday’s pathology presentation, I should probably be thinking only about the peer review that still remains on my desk. Instead, my attention was caught by something much more ordinary: the number of celebrity obituaries that seem to appear in the news these days.

Actors, athletes, cultural figures, business leaders, politicians—the list seems endless.

Of course, people are not necessarily dying more often. What may have changed is the range of people we now regard as “famous.” As society has become more diverse, so have our interests, our media, and the people we recognize.

Perhaps the growing number of obituaries we notice is really another symptom of something much larger: the sheer saturation of information in modern life.

It has been raining again since early this morning.

How long is this going to continue?

There was a movie in which Tokyo became submerged by endless rain, and lately it feels rather like that.

Yesterday, I somehow managed to get through my pathology presentation without serious trouble.

“Got through it” may not be quite the right expression. My father liked to say that someone had kemuri ni maita—literally, “wrapped people in smoke,” meaning that he had somehow talked his way through without giving a perfectly clear answer.

That may be closer to what I did.

In any case, one burden has been lifted from my shoulders.

Once I finish the peer review I rather carelessly agreed to take on, this recent period of busyness should finally settle down.

Lately, I seem to hear about the deaths of famous people all the time.

This morning’s newspaper also carried the obituary of an actor who made me think, “Ah yes, he had a rather distinctive presence.”

Cultural figures, athletes, actors, business leaders, politicians.

People from every field die every day.

Of course, there are many whose names I do not know, and others I had completely forgotten.

At times like that, I sometimes feel slightly embarrassed by my own ignorance.

How could I not have known someone like this?

But there are simply so many such people now that I have begun to wonder whether there is any reason to feel embarrassed at all.

Perhaps there are simply too many people who can now be called “famous.”

One reason may be the increasing diversity of society.

In the past, people’s interests were not divided into nearly as many categories as they are today.

In entertainment, for example, famous people tended to come from a relatively limited world: movie stars from the old studio era, kabuki actors, singers, and a few other highly visible groups.

Now, however, the actors, television personalities, presenters, and commentators who supported the television age are growing older one after another.

As a result, we increasingly come across obituaries that make us say, “Oh yes, I remember that person.”

The same is true of sports.

In the past, baseball, sumo, professional wrestling, and boxing were among the most visible spectator sports in Japan.

Today, basketball, rugby, tennis, golf, athletics, martial arts, and many other sports all have large groups of devoted fans.

Many of the athletes from these later-growing sports are still relatively young, so we do not yet hear many obituaries from those generations.

But several decades from now, their deaths too will undoubtedly be reported one after another.

Social diversification is not, of course, increasing the number of deaths themselves.

What it has done is greatly expand the range of people whom we recognize as “famous.”

And as that range expands, we encounter more obituaries.

It is a rather strange phenomenon.

But perhaps it is really the result of the enormous increase in the amount of information surrounding us.

Will we eventually start seeing obituaries even for less widely known public figures?

Or will the number become so overwhelming that news organizations will decide there is little point in reporting every one of them?

Perhaps one day, we will simply think,

“I wonder what happened to that person?”

Then we will look them up on Wikipedia and discover either,

“Oh, they are still alive,”

or,

“What? They died years ago?”

Perhaps that is how things will gradually change.

The deaths of people we have already forgotten may no longer be something that needs to be actively delivered to us as news.

In a modern society where information is increasing at an explosive rate, even keeping track of who has died is becoming one more burden of information to absorb.

In an age of information overload, even an obituary can become one more piece of information we are simply too full to take in.

・・・

Vocabulary for Learners

obituary
A notice or article reporting someone’s death, often describing their life and achievements.
死亡記事、訃報

distinctive presence
A quality that makes someone memorable or recognizable.
独特の存在感

public figure
A person who is widely known because of their work, position, or activities.
著名人、公人

diversification
The process of becoming more varied or divided into different types.
多様化

devoted fan
A person who strongly supports and follows a particular team, athlete, artist, or activity.
熱心なファン

information overload
A situation in which there is so much information that it becomes difficult to process.
情報過多、情報の飽和

keep track of
To continue knowing what is happening with someone or something.
動向を把握する、追い続ける

absorb information
To take in and understand information.
情報を取り入れて理解する

#InformationOverload #CelebrityObituaries #SocialChange #Media #ModernSociety #KAMAKURA #JapanesePathologist

Am I Someone Who Can’t Make an Effort?

It is raining heavily again today, and I find myself wondering how long this weather will continue.

Yesterday, while looking through some old drafts that I had never published, I came across one I had started writing in April 2024. It was about something I often feel whenever I have to give a presentation: how much other people seem to know, how thoroughly they prepare, and how often I end up feeling embarrassed by what I have overlooked.

As it happens, I have another presentation at a small medical meeting tonight, so I decided to bring that unfinished piece back to life.

But once I started reading it again, the subject somehow shifted. From presentations, to studying, to effort, to talent—and finally to a rather uncomfortable question.

Am I simply someone who cannot make enough effort?

It is raining heavily again today. How long is this going to continue?

Yesterday, while looking through some articles I had shelved and never published, I came across one about something I often think about when giving presentations.

I had started writing it in April 2024, but never finished it. As it happens, I have an opportunity to give a presentation at a small medical meeting tonight, so I decided to revive it.

The title was Everyone Knows So Much and Studies So Hard.

In my case, whenever I present at a conference—or, of course, at a medical meeting or academic congress—I usually end up embarrassing myself in one way or another.

There are many different ways to define “embarrassing,” but sometimes I have not examined the pathology slides carefully enough, sometimes I have not thought deeply enough about the case, and sometimes I simply have not done enough background research.

After all, when someone asks a pathologist for a diagnosis, they are not merely asking for a label. They are asking for some kind of professional “opinion.” I should always be conscious of that, but I do not think I am conscious enough of it.

The fact that I was still saying things like this even when I had reached sixty is probably a problem in itself, but it was true, so there was not much I could do about it.

Still, whether they are clinicians or pathologists, the people who are genuinely “good” at what they do seem to know an extraordinary amount—and they study constantly.

Of course, no one wants to entrust their life to a doctor who knows nothing, and if you want to know a great deal, you have to study.

And that was where the draft ended.

Hmm.

It has now been almost three years since I turned sixty, and I am still standing up in front of people and embarrassing myself. Even for tonight’s presentation, I still cannot come up with a satisfactory conclusion.

No progress.

There is now less of my life ahead of me than behind me, so perhaps I should be asking whether this is really acceptable.

But then again, perhaps I was never one of those “capable people” in the first place.

If I am not naturally capable, then the obvious answer is that I should compensate by working harder.

But perhaps the people who are capable of making that effort are precisely the people we call “capable.”

And someone like me, who cannot make enough effort, will therefore never become one of them.

Making an effort is genuinely difficult.

To make an effort, you have to give up something you would rather be doing.

But what exactly is it that you want to do?

Become an admirable person?

Become better educated?

Make a name for yourself in the arts?

Then again, is working toward something you genuinely want really “effort”?

If you are doing it because you want to achieve something, perhaps it does not even feel like effort.

And what if you had talent?

Would that solve the problem?

Probably not.

Even if you had a reasonable amount of talent and could get quite far without much struggle, in the end, without sustained effort, you would never truly excel.

Hmm.

Instead of wasting time thinking about something this pointless, I should simply get back to preparing for tonight’s presentation.

But perhaps the fact that I am sitting here thinking about all this instead is yet another sign that I really am someone who cannot make enough effort.

Or perhaps I simply lack ability.

How did an article originally titled Everyone Knows So Much and Studies So Hard end up becoming something like this?

Or perhaps this is all simply because I am getting nervous.

Perhaps what I call a lack of effort is sometimes nothing more than anxiety looking for an explanation.

・・・

shelve
To decide not to continue or use something for the time being.
いったん棚上げにする、お蔵入りにする

revive
To bring something back into use, activity, or attention.
復活させる、よみがえらせる

background research
Research done to understand the context or details of a subject more deeply.
背景を理解するための調査、下調べ

entrust
To give someone responsibility for something important.
任せる、委ねる

compensate for
To make up for a weakness, disadvantage, or lack of something.
不足や弱点を補う

sustained effort
Effort that continues steadily over a long period of time.
継続的な努力

excel
To be exceptionally good at something.
秀でる、卓越する

masquerade as
To appear to be something different from what it really is.
～のように見せかける、～の姿をとる

 

#Effort #SelfReflection #Learning #MedicalLife #Pathology #KAMAKURA #JapanesePathologist

Autumn Is Finally Arriving

It was raining again this morning, but the air felt completely different from the humid heat we had grown used to. The temperature had dropped, and there was a distinct chill in the air.

It seems that autumn has finally begun to arrive in Kamakura. The seasonal rain front is being pushed southward by a high-pressure system from the north, and the long summer may be coming to an end earlier than expected.

At the same time, with so much unusual weather in recent years, even a welcome change in temperature can feel slightly unsettling.

For me, this change of season has coincided with another small transition: recovering from an injured Achilles tendon and deciding when I should finally stop using my walking stick.

It was raining again this morning, but unlike the humid heat we had been living with until now, the temperature had dropped and the air felt pleasantly cool.

The autumn rain front seems to have been pushed southward by high pressure from the north, bringing autumn with it.

I am glad that the summer heat may come to an end about ten days before the autumn equinox period, but considering the strange weather we have been experiencing in recent years, it also feels a little ominous.

In front of Kamakura Station, there was already a notice announcing the annual autumn festival at Tsurugaoka Hachimangu Shrine.

 

At night, many people had been practicing traditional festival music enthusiastically in the shrine grounds. I hope they will once again have the chance to show the results of all that practice this year.

The pain in the Achilles tendon of my injured right leg has improved considerably, although it is still clearly swollen compared with the left side.

I know that the tendon was overstretched, but whether there is inflammation, bleeding, or something else going on is impossible for me to know without actually looking at the tissue under a microscope.

Unfortunately, given where the injury is, it is not exactly easy to inspect it closely every day.

Still, it seems that I have somehow managed to get through the worst of it.

Yesterday, I went to the hospital where I work without my walking stick.

The difference was remarkable.

Without the stick, nobody paid any particular attention to me. I was simply an older guy walking slowly.

Until the day before, people had been noticeably considerate. Without the stick, that consideration disappeared almost completely.

Since there is still some pain, I brought the walking stick with me again today.

In fact, walking with it still makes my leg considerably more comfortable. And if the stick can turn other people's irritation at my slow walking into a little sympathy, perhaps I might as well keep using it until the pain is almost completely gone.

As I wrote recently, I have been surprised by how many people are kind and considerate toward someone who appears to have a physical handicap.

My rough impression is that, out of ten people, about four clearly notice the walking stick and make an effort to accommodate me.

Another four appear to ignore it, but quietly shift aside just a little.

The remaining two completely ignore it, and occasionally someone even seems to make things more difficult.

So perhaps those are the only people I really need to watch out for.

There is, however, another problem.

Since I started using the walking stick, the amount I walk has decreased considerably, which means I am burning fewer calories.

I walk more slowly, and instead of climbing two flights of stairs as I usually do, I sometimes take the elevator.

Perhaps not surprisingly, my weight has gradually started creeping upward again.

So I am beginning to think that if I can walk without the stick, even with a little pain, perhaps it is time to stop using it.

At the same time, part of me would rather continue accepting the kindness of the considerate people around me.

And yet, somehow, I also feel slightly guilty about doing so.

I am still not quite sure what the right thing to do is.

Perhaps the hardest part of recovery is deciding when help is still necessary—and when it has simply become comfortable.

・・・

humid heat
Hot weather with a lot of moisture in the air, making it feel uncomfortable.
蒸し暑さ

autumn rain front
A seasonal weather front that often brings prolonged rain to Japan in early autumn.
秋雨前線

autumn equinox
The time in autumn when day and night are approximately the same length.
秋分

annual festival
A traditional event or celebration held once every year.
例大祭、年に一度の祭り

festival music
Traditional music performed during local festivals, often with drums and flutes.
お囃子

Achilles tendon
The strong tendon connecting the calf muscles to the heel bone.
アキレス腱

overstretched
Stretched farther than is normal or safe.
伸ばされすぎた

walking stick
A stick used to support the body while walking.
杖

make an effort to accommodate someone
To adjust one's behavior in order to make things easier for another person.
人に配慮する

creep upward
To increase slowly and gradually.
じわじわ増える

feel guilty about doing something
To feel that something one is doing may not be entirely right or fair.
〜することに後ろめたさを感じる

 

#AutumnInJapan #KamakuraLife #WalkingStick #EverydayObservations #ChangingSeasons #KAMAKURA #JapanesePathologist

Be Kind to Others, and Make Yourself Happy — Kon-kimo Enters Its 20th Year

This blog, Konna Kimochi de Iraretara — loosely, “If Only I Could Keep Feeling This Way,” or simply Kon-kimo — began on September 9, 2007. Today, it enters its twentieth year.

Over the years, writing here has become almost as natural to me as breathing. Yet there were times when I could barely write at all, and times when I simply did not want to. Longtime readers may remember those periods. Somehow, with encouragement from many people, I kept going.

So what have I really been writing about all these years? And what has this blog given me — or perhaps taken away from me?

Looking back, I find myself returning to one simple idea that has been part of this blog from the beginning: be kind to others, and make yourself happy. Nearly twenty years later, it still sounds simple. And it is still remarkably difficult.

This blog is called Konna Kimochi de Iraretara, which I shorten to Kon-kimo.

I started it on September 9, 2007, and today it finally enters its twentieth year.

These days I write every day almost as naturally as I breathe, so I no longer feel that it is particularly difficult. But longtime readers may remember that there were periods when I could hardly write at all, and others when I simply did not feel like writing.

Each time, many people encouraged me, and thanks to them I was able to keep putting down whatever happened to be on my mind.

So what is it that I have consistently written about through this blog?

What have I gained from it? And what, if anything, have I lost?

My daughter, who was one of the reasons I began this blog in the first place, is now a fully grown adult, working hard on the other side of the world.

As you might expect of a father and daughter, she has a slightly cynical streak that resembles mine. Fortunately, she has also inherited just the right amount of my wife’s kindness. She has friends she can trust, and from where I stand, that gives me some peace of mind.

Still, I sometimes wonder what possessed me to say to my elementary-school-aged daughter,

“You’re not very good at washing dishes, so you don’t have to do it.”

What kind of father says something like that?

I am fairly certain that this is one of the things I ought to apologize for before I die. I suppose my long-running apologies to my daughter are still not over.

That episode appeared in the very first post I wrote on this blog, on September 9, 2007.

Looking back at it now, I was a little surprised to find that the idea behind this blog was already there from the beginning. I wrote that if I could be kinder to other people, I might be happier myself — and that I wanted to try to treat not only my family, but even strangers I passed on the street, with kindness.

In other words, “Be kind to others, and make yourself happy” was not something I came up with years later. It was there on the very first day.

Perhaps that is exactly why the words “Be kind to others, and make yourself happy” have become a lifelong theme for me.

But it is not nearly as easy as it sounds.

I am still too hard on other people, and I often end up turning that harshness back on myself.

I do believe that making yourself happy can also help make other people happy. But the very meaning of happiness seems to be changing in today’s world, and it is no longer something that can be neatly summed up in a single phrase.

And yet, after keeping this blog going for all these years, I find myself thinking that Konna Kimochi de Iraretara really was a good title.

It suits a place where I can simply write down what I think and feel from day to day.

I am glad that today, of all days, I was able to realize that once again.

If I keep writing as I have until now, by the time another twenty years have passed, I will probably be nearing the end of my life.

Even so, I hope I will still be thinking about one thing after another each day — and writing some of it down.

What have I lost?

Nothing comes to mind, really, except the enormous amount of time I have spent writing.

But it was time I needed.

Twenty years of writing may have taken a great deal of time, but perhaps that time was never truly lost.

 

・・・

My First Blog Post — September 9, 2007 

The brief cool spell after the typhoon was over almost immediately, and the heat returned.

Or rather, I suppose it was the humidity.

I had been fairly busy with a couple of small academic meetings over the previous two days.

Today, I had planned to spend the whole day with my daughter. But when she offered to help with the dishes, I said, “You don’t have to help,” because I thought she was not very good at washing them.

I ended up discouraging her just when she was trying to be helpful.

My wife prompted me to go back, so we washed the dishes together and I apologized.

Still, I know I hurt her.

Something similar happened at yesterday’s meeting, too. Lately, I seem to have been treating people more coldly than I should.

Something to reflect on.

If I could simply be kinder to other people, I think I would be happier myself.

And yet I keep forgetting that.

So today, I am going to try to be kind — to my family, and even to the strangers I pass on the street.

September 9, 2007

・・・

Vocabulary for Learners

longtime reader
Someone who has been reading a writer, blog, or publication for many years.
長年の読者、古くからの読者

cynical streak
A tendency to doubt people’s motives or to see things in a somewhat skeptical way.
少し皮肉っぽいところ、物事を冷めた目で見る傾向

penance
Something done to express regret for a past mistake or wrongdoing. Here it is used somewhat humorously.
償い、懺悔。ここでは少しユーモラスな意味合い

backlash
A negative reaction or consequence that comes back after something you have done.
反動、しっぺ返し

nearing the end of one’s life
Approaching the final stage of life. A softer expression than saying “close to death.”
人生の終わりに近づく、死期が近づく

#DailyBlog #LifeReflections #JapaneseLife #WritingLife #Kindness #Kamakura #JapanesePathologist

Young People, Aim for the Blue Sky

After days of gray skies, a glimpse of blue appeared between the clouds this morning. It reminded me of something else I hope young people in Japan will continue to seek: the wider world beyond the familiar horizon.

For days, I had been longing to see a blue sky, and finally, this morning, I caught a glimpse of one between the clouds.

Even a brief patch of blue can brighten my mood.

The heat also seems to be making a comeback after a while, but apparently it will not last very long. On that point, I suppose I will simply have to accept it.

There is something I must do first when I arrive at the hospital today.

I need to help a clinician who is preparing to study abroad.

There are some documents that I have to write, and the deadline is rapidly approaching.

The paperwork itself is rather tedious. But more than that, when I think that I can be directly involved in the future of a younger colleague in this way, I feel both the weight of the responsibility and, at the same time, a certain happiness.

In recent years, we often hear that fewer young Japanese people are going abroad.

Even if only for a short period, I hope they will go out into the world and broaden their horizons.

In my own case, I spent only three months abroad. During the weekdays, I was practically confined to the laboratory, working hard with my eyes fixed on a microscope. Yet that experience continues to influence me even today.

It was not simply a matter of learning technical skills.

I want young people to encounter many kinds of “difference,” including differences in lifestyle, and to experience diversity firsthand.

Otherwise, Japan risks drifting back toward a modern version of sakoku, the isolationist policy of the past.

Of course, this would be very different from the sakoku of an age when there were no modern means of communication.

Precisely because we now live in an age when information from anywhere in the world can be obtained instantly, there is still great value in actually going abroad, seeing things with one’s own eyes, and experiencing differences for oneself.

Fortunately, Japanese researchers and professionals who go abroad are generally expected to return to Japan eventually. That should make host institutions relatively comfortable about accepting them.

Young applicants should make the most of that advantage.

And those who return will undoubtedly contribute to the advancement of science and culture in Japan.

But then comes the difficult question: who pays for studying abroad?

The other day, at a university, I saw a poster outside a medical department advertising a grant to support overseas study. The amount of support was stated in Japanese yen.

Apparently, the grant has existed for many years, but at today’s exchange rates, the amount would hardly be sufficient.

I think such support should instead be calculated on the basis of U.S. dollars or euros.

Of course, individuals themselves must make an effort to finance their time abroad. But we should not leave the burden entirely to them.

Government and the private sector should work together to create a system that makes it easier to send young people out into the world.

I hope as many young people as possible will aim for the blue sky they can see beyond the clouds.

And yet, human connections are strange things.

Only a few years ago, this person and I did not even know each other’s faces.

Now, before I knew it, I find myself deeply involved in an important turning point in that person’s life.

That is exactly why I want to give my full support.

Beyond the clouds, there is always a wider sky—and I hope our young people will have the chance to reach for it.

・・・

Vocabulary for Learners

broaden one’s horizons
To gain new knowledge, experiences, and ways of thinking by encountering unfamiliar people, places, or ideas.
視野を広げる。新しい経験や考え方に触れて、自分の世界を広げること。

be confined to
To have to stay within a limited place or situation. Here, “confined to the laboratory” means spending almost all one’s time working in the lab.
〜に閉じこもる、〜に缶詰になる。

firsthand
Directly through one’s own experience rather than through someone else’s description.
直接、自分自身の経験を通して。

drift back toward
To gradually move or return toward a previous condition, often without deliberately intending to do so.
徐々に以前の状態へ戻っていく、逆戻りしていく。

host institution
An organization, university, hospital, or research center that receives and supports a visiting student or researcher.
留学生・研究者を受け入れる大学、病院、研究機関などの受入先。

make the most of
To use an opportunity or advantage as effectively as possible.
〜を最大限に活用する。

exchange rate
The value of one country’s currency compared with another country’s currency.
為替レート、通貨の交換比率。

turning point
An important moment when a situation, career, or life begins to change significantly.
転機、人生や状況が大きく変わる節目。

#StudyAbroad #YoungResearchers #GlobalExperience #MedicalEducation #SupportTheNextGeneration #Kamakura #JapanesePathologist

When I Realize How Foolish I Can Be

A report about soaring protein prices in the United States made me think about weight loss, metabolism, and the strange ways we humans often work against our own intentions.

Protein supplements are reportedly becoming much more expensive in the United States.

One reason, apparently, is that more people are taking protein to compensate for the loss of muscle mass that can accompany weight loss from obesity medications. It is one of those strange chains of cause and effect in which one thing leads unexpectedly to another.

A very human story, somehow.

Ideally, of course, we would simply live in a way that keeps us from becoming obese in the first place. But that is easier said than done. We gain weight, take medication to lose it, and then start drinking protein shakes so that we do not lose too much muscle along the way.

I myself have recently watched my weight begin climbing again, and I had started thinking that perhaps I wanted one of those weight-loss drugs. But if losing weight also means losing muscle, then I have to think twice.

Muscle mass is going to decline with age anyway. Surely deliberately accelerating that process would not be a good idea.

The foolish part of being human is that we often fail to notice how absurd some of our own thinking can be.

I have certainly had my share of foolish ideas.

For a long time, for example, I did not really understand why eating fatty foods made me gain weight.

Somewhere in the back of my mind, I seem to have thought that even if I absorbed a few grams of sugar or fat, I could simply excrete the same amount later.

The whole concept of metabolism was missing from that picture.

I somehow forgot that excess energy is stored in the body as fat. Meanwhile, I continued eating as I pleased and was not exercising enough either.

Only recently, after realizing that my weight does not come down easily no matter how much I try to improve my diet, did something embarrassingly obvious finally occur to me.

The problem of “IN and OUT” is not really about the physical weight of what goes into and comes out of the body.

It is about energy.

I regret having thought about it so superficially, although by now I sometimes feel that I realized it rather late.

Still, better late than never.

Just when I had decided to become more active and take Anne for longer walks, I injured my ankle.

Then came a medical conference, where I spent almost the entire day sitting, followed by dinner gatherings in the evening.

Bad luck, perhaps.

Or perhaps the world simply has a remarkable talent for discouraging us whenever we finally decide to do something sensible.

But maybe this is what human beings are like most of the time.

Foolish, perhaps. Ridiculous, perhaps.

We ourselves are completely serious about what we are doing, while somehow continuing to do things that work against what we actually want.

We take ourselves seriously, even while behaving in ways that make us look wonderfully, hopelessly human.

・・・

Vocabulary for Learners

compensate for
To make up for something that has been lost or reduced.
「補う」「埋め合わせる」

cause and effect
The relationship in which one event produces another event.
「因果関係」

easier said than done
Something that sounds simple but is actually difficult to do.
「言うは易く行うは難し」

think twice
To reconsider something carefully before doing it.
「よく考え直す」

accelerate
To make something happen faster.
「加速させる」

metabolism
The chemical processes in the body that use and store energy.
「代謝」

excess energy
Energy taken into the body beyond what it immediately needs.
「余剰エネルギー」

better late than never
It is better to do something late than not to do it at all.
「遅くても、しないよりはまし」

work against
To act in a way that makes a goal harder to achieve.
「〜に逆らって働く」「〜の妨げになる」

hopelessly human
A slightly humorous expression meaning imperfect in a very recognizably human way.
「どうしようもなく人間らしい」

 

#WeightLoss #Protein #Metabolism #HealthyAging #MuscleMass #Obesity #JapanesePathologist #HumanNature #Kamakura

 

Cassette Tapes on Our Wedding Anniversary

A rainy weekend kept us at home, and an old audio system unexpectedly brought back a sound we had not heard in decades. On our 35th wedding anniversary, a cassette tape from the days before we were married opened the door to a flood of memories.

Rain from early morning.

They say that by tomorrow, a linear rainband may finally develop over southern Kanto, including Kanagawa Prefecture.

Up until now, whenever I heard about heavy rain in Kyushu, Hokuriku, or Tohoku, it somehow felt like something happening somewhere else. But this time, it may be where I live that gets hit.

I have work tomorrow, so naturally my first thought is, this could be a problem.

Then again, perhaps this is exactly the sort of situation where assuming, “I’ll probably be fine even if I push things a little,” is not such a good idea.

In any case, what really matters is whether the Yokosuka Line will be running tomorrow. I’ll think about it when the time comes.

 So, once again this weekend, the rain left me stuck at home wondering what to do. I decided to start by connecting the speakers to that audio system I wrote about before.

I still haven’t bought a stylus for the record player, but since I had nothing else to do, I thought I might at least get the speakers hooked up.

Then I went online to look for a stylus and discovered that they are actually rather expensive.

That made me stop and think. Before spending that much, I figured I should first make sure the system could produce any sound at all.

Fortunately, there is also a cassette deck, so I thought I would start with that. My wife, who has always been good at keeping things, dug out one of those upbeat cassette tapes we used to play on our drives when we were dating nearly forty years ago.

Naturally, I rewound it all the way to the beginning.

The way the rewind slows down gently near the end reminded me that this had once been considered a high-end cassette deck.

Then I pressed the PLAY button, and there it was again—the same slightly muffled sound we had listened to all those years ago.

“Ah, analog sound!”

My wife and I were both struck by the nostalgia.

And by the sound coming out of the speakers as well.

To a serious audiophile, this may sound utterly ridiculous, but it had been a very long time since I had heard music this loud coming from something other than a television—from a machine built for the sole purpose of producing sound.

Ever since the Walkman appeared, most of my listening has been through headphones or earphones.

And how many years has it been since cassette players disappeared from car stereos?

So perhaps it really has been that long.

Listening to it again reminded me how good analog sound can be.

Today is our 35th wedding anniversary.

Quite unexpectedly, we found ourselves remembering all sorts of things from before we were married.

And so, with a clear conscience, I decided it was time to buy that record-player stylus and clicked “Buy.”

An old cassette tape brought back not only an old sound, but also the days before we became husband and wife.

・・・ 

Vocabulary 

Linear rainband
A narrow, elongated zone of repeatedly developing rain clouds that can bring extremely heavy rainfall to the same area for several hours. The term is commonly used in Japanese weather reporting.

Yokosuka Line
A major JR commuter railway line running through Tokyo and Kanagawa, including Yokohama and Kamakura.

Stylus
The small needle that traces the grooves of a vinyl record and converts the vibrations into sound.

Cassette deck
A home audio component designed specifically for recording and playing cassette tapes.

Upbeat
Lively, energetic, and cheerful. Here, it is used to convey the sense of the Japanese expression “ノリノリ.”

With a clear conscience
Used here somewhat humorously for “心置きなく”—meaning that after confirming the system still worked, there was no longer any reason to hesitate about buying the stylus.

#weddinganniversary #cassettetape #analog #cassettedeck #vinyl #nostalgia #music #Walkman #Japan #dailyessay #memories