Living With Peace Enforced by Force

 Is this, too, a symbol of MAGA?
America remains overwhelming in its power—and the world is being reshaped under that weight.

 

Reports say the United States launched attacks on Iran and killed figures close to the core of the regime.
If strikes are carried out without any formal declaration of war, legal arguments will follow. But I’m no longer sure how much those arguments matter in a world that increasingly moves by sheer momentum and capability.

This is an operation justified by America’s own logic. How other countries truly interpret it is still hard to read. An emergency UN Security Council session is expected to bring some clarity, but I doubt it will change the course of events.

For Japan, the most immediate anxiety is the safety of the Strait of Hormuz. If energy transport becomes unstable, fuel prices may rise. That, in turn, could revive the argument that Japan has no choice but to lean on nuclear power—casting the slow pace of reactor restarts in a harsher light.

I can’t help thinking of the last war, when Japan was thoroughly crushed by America. Whether it was necessary to fight on through Okinawa and even the atomic bombings—no one can truly know now. History offers no “what if.” And yet, sometimes I imagine that even if Japan had never started the Pacific War, we might eventually have been forced into submission somewhere, somehow, by a greater power.

America is vast, wealthy, and formidable. It attracts talent, builds rational systems, and protects freedom—while also carrying division and dissatisfaction at home. Still, Americans chose Trump as president. And under him, higher tariffs and hardline interventions—toward Venezuela, toward Iran—signal that the global order is shifting in real time.

Trump seems to embody a certain lesson: this is how power is used. During the campaign he survived an assassination attempt by a narrow margin; at times I wonder what the world would look like if that shot had landed. But terrorism must never be justified. I’m glad his life was spared.

And yet, I cannot easily say whether it is right to subdue other nations by force. If someone answers, “Talks never worked—this was the only way,” it becomes strangely difficult to argue back.

Peace is not preserved simply by staying silent.
Sometimes peace is maintained—perhaps even “won”—through force.

But whose peace is it?
And what is “peace,” really?

The Return of the Weight Rebound

After shedding a few pounds during a freezing but active stay in New York, I have found myself drifting back toward old habits. Commuting, long hours, and small indulgences have quietly undone my progress.

Recently, my weight has started creeping up again.

During the New Year holidays in New York, despite the bitter cold, I walked everywhere. Perhaps that constant movement helped, because I actually lost a little weight.

But after returning to Japan, weekdays have become what they usually are: long hours on the train commuting, and only occasional walks with my dog, Anne. The reason is obvious.

Lack of exercise. What to do.

I leave home at 7 a.m. and return after 8 p.m. It is difficult to insert exercise into either end of that schedule. People say, “You make time for what matters,” but it is not quite so simple.

My wife suggests doing squats while brushing my teeth. As someone who once belonged to the athletic crowd, I cannot help feeling that both activities would suffer if combined.

And so, with such excuses, inactivity accelerates. I have reached 78 kilograms. The 75 kilograms I once considered my benchmark now feels like a distant memory.

Although I try to reduce carbohydrates, yesterday I had yakiniku at a restaurant called Nikuno Mansei for the first time. When my wife said her rice portion was too much and passed some to me, I added it to mine without hesitation.

I sometimes wonder whether even occasional indulgences make the body rejoice and immediately shift into storage mode.

Recently, I have also been casually drinking a bottle of sake I bought in Motomachi. I usually choose red wine to be mindful of sugar intake, but even that becomes another story when it is every day.

So this evening, I walked a little longer than usual—about an hour and a half.

Tomorrow morning, at my usual weigh-in time, we shall see what the scale says.

 

Rediscovering Akihabara After Years Away

Although I travel to Tokyo every day for work, I rarely step off at any station other than the one nearest my hospital. Tokyo Station, Shinjuku, and occasionally Shibuya — that is about it.

Recently, however, I found myself returning to Akihabara with my wife, and what I saw felt like stepping into a different era.

When heavy snow fell earlier this winter, I attended a conference near Ochanomizu. That neighborhood seemed comfortingly unchanged.

But Akihabara was another story.

The last time I truly walked its streets was several years ago, when I attended a pathology workshop. Since then, I had only briefly passed through to transfer to the Tsukuba Express. In other words, I had not properly visited since before the pandemic.

The transformation was striking.

From the Chuo Line train I had already noticed that the iconic Meat Mansei building was gone. What I did not realize was that Yamagiwa — once a landmark electronics store — had actually closed fifteen years ago. My wife and I felt like characters from an old Japanese folktale, like Urashima Taro returning to find the world transformed.

While searching for that “phantom” Yamagiwa, I encountered another surprise: rows of young women dressed as maids, calling out to passersby to promote maid cafés.

The sight was impressive in scale, yet also strangely unsettling. Akihabara, once known primarily as “Electric Town,” has clearly evolved into something else — a global center of anime, gaming, and pop subculture.

Still, tucked between the colorful storefronts, a few small electronic parts shops remain. Stepping inside them felt like discovering fragments of an earlier Akihabara, preserved in quiet corners.

As expected, there were many international visitors. What caught my attention, though, was a group of foreigners gathered around a coin-operated parking lot, displaying customized cars.

Perhaps it was a meeting of enthusiasts, a celebration of Japanese car culture.

Standing there, I wondered what exactly they were sharing — and how this district, once devoted to circuits and solder, had become a stage for so many different worlds.

 

Can We Think in Proportion to What We Have?

 As February—precisely four weeks long—comes to an end, new demographic data quietly marks another turning point. Japan’s annual birth count has fallen to a historic low. Rather than asking how to reverse the trend, perhaps it is time to ask a different question: how should we design a society that is no longer expanding?

 

February, neat and exact at four weeks, ends today.

Last year’s number of births reportedly fell to just over 700,000—the lowest on record.

The decline in birthrate may no longer be something we can simply halt.
Its opposite—an era of many children—is not something that can be summoned at will.

It is undeniably lonely to imagine a society with fewer children.
Yet if the population is shrinking, might there not be ways of thinking and living that correspond to that reality?

Japan cannot be compared with countries whose populations exceed a billion.
But even as our numbers decline, we remain comparable to nations such as Germany, the United Kingdom, and France—countries that continue to sustain stable and mature societies.

Advances in AI make further labor-saving increasingly possible.
Both intellectual and physical work may not be entirely replaced, but supported and streamlined through greater efficiency.

There still appear to be many unnecessary tasks in the world—duties that continue more out of habit than necessity.
Reducing such work is not an act of coldness. It may instead mean redirecting limited time and human effort toward what truly matters.

With more margin in daily life, people may become gentler.
Marriage and child-rearing might be considered not as burdens but as choices.

When I see young physicians struggling to rearrange schedules in order to raise children, I cannot help feeling that our institutions are still designed on the assumption of constant growth.

To stop expanding does not mean to decline.
To shrink can also mean to increase density—to refine and concentrate what is essential.

If we are fewer, then perhaps we can imagine a quieter, sustainable society—one without excess, yet without deprivation.

Rather than lamenting demographic decline,
perhaps we should accept it and consider what to discard and what to preserve.

That may be closer to our responsibility as those living in the present moment.

The other day, while examining a routine hematoxylin and eosin (H&E) slide—the most common stain used in pathological diagnosis—I felt a subtle sense of discomfort. Something did not quite fit.

That small “unease” eventually led to a diagnosis that would completely change the patient’s treatment plan.

 

Looking at the H&E section, I had the impression that the case did not follow the usual pattern. Rather than staying on the expected diagnostic track, I began to suspect a different disease altogether. To explore that possibility, I performed immunohistochemistry—a method used to identify specific proteins within tissue.

The result confirmed that my sense of discomfort had been correct. The diagnosis was established. Fortunately, it was a condition in which the treatment strategy would change 180 degrees depending on whether it was present or not.

But what struck me most happened afterward.

Once the diagnosis was confirmed by immunohistochemistry, I returned to the original H&E slide. This time, the disease was unmistakable. The abnormal cells expressing that protein seemed to leap into view.

“Were you all here the whole time?” I almost wanted to say.

It reminded me of those online puzzles in which you move a single matchstick to make an incorrect arithmetic equation correct. Before you know the answer, it feels nearly impossible. Once you see it, however, it becomes obvious.

Why does everything suddenly become clear once you know the answer?

Of course, if you do not know the disease at all, there is no starting point. That would be like attempting the arithmetic puzzle without knowing how addition or subtraction works. But beyond that basic knowledge, something interesting happens in the diagnostic process.

As I once discussed with AI, pathological diagnosis begins in a state of exploration. We look at tissue without knowing what disease is present and search for patterns. When a diagnosis is established, it means the disease has been recognized. And once recognized, a pattern forms.

That is why common diseases—such as gastric cancer, colorectal cancer, or breast cancer—can be diagnosed almost instantly. We have encountered them countless times.

Rare diseases are different. By definition, they are rare. Over ten years, one might diagnose 10,000 cases of common cancers, while encountering only two or three cases like the one I saw the other day. It is difficult to build stable patterns from such infrequent exposure.

Still, the diagnostic process itself is fascinating. Under the microscope, all the information initially appears fragmented and unstructured. Yet once various techniques are applied and a diagnosis is secured, the scattered pieces suddenly organize themselves into a coherent structure. A pathway to the diagnosis becomes visible.

In theory, once that pathway is learned, the next case should be easier. In reality, if you encounter such a case only once every two or three years, memory fades.

Excellent pathologists, however, seem to retain a vast number of such patterns. They have many “drawers” to pull from. My own drawers are not particularly numerous, although having seen many rare diseases, I know this field reasonably well. Even after more than thirty years in pathology, I still feel that my training is incomplete. The depth of medicine is profound.

People often say that AI will eventually replace pathologists. It is true that AI excels at pattern recognition. If trained on an enormous number of images, it can achieve high accuracy in diagnosing common diseases.

However, pathology is not merely image classification.

It requires the ability to sense subtle “unease,” to question whether a case is diverging from the expected path, and to reconstruct the diagnosis into a meaningful narrative once it is established. That is where the human role still lies.

AI reorganizes existing knowledge. It does not yet originate hypotheses from a vague sense of discomfort.

That said, with sufficient training data, AI can recognize patterns of common diseases, and such systems are already being implemented. A portion of the pathologist’s workload may indeed be delegated.

In a time of pathologist shortages, that may be, in some ways, welcome news.

Choosing Progress Over Sighs

 As the seasons shift and the weather turns uncertain, it is easy to feel unsettled—not only by the climate, but by the state of the nation. Yet even in times of economic strain and geopolitical pressure, the question remains: will we continue to sigh over decline, or consider how to move forward?

 

The change of seasons always brings unsettled weather.

This week the skies have been gray, the temperature has refused to rise, and it feels as though winter has returned.

For the first time in a while, I stepped outside carrying a long umbrella.

Perhaps the fact that I rarely use one anymore is, in part, a quiet sign of climate change.

President Trump of the United States has announced new tariff measures, and Japan will likely feel their impact once again.

China’s stance toward Japan has also grown more severe, with new measures introduced just yesterday.

It is now undeniably a major power.

Meanwhile, Japan seems to be losing its former affluence. Even maintaining infrastructure is no longer easy.

We must rely on foreign labor, yet the framework for accepting and integrating workers is still far from fully organized.

Japan’s decline is often traced back to the collapse of the bubble economy.

But there is little point in endlessly lamenting the so-called “lost thirty years.”

In the recent general election, Prime Minister Sanae Takaichi’s message was clear: Japan can still do it. The future begins now.

Rather than dwelling on the long rule of the Liberal Democratic Party with regret, she spoke of hope for what lies ahead. That left an impression on me.

There is no reason to expect a rosy future awaiting this country.

Still, with the mandate gained under the name of Sanae Takaichi, I hope that over the next four years Japan can move forward, even if only a little.

Reflection is, of course, necessary.

But sighing alone will lead nowhere.

No matter how small the action may be, we must ask what can be done to help this country move ahead.

Each of us has a part to consider.

Why Institutions Should Be Clearly Defined

 It is warm again today—perhaps too warm to believe that spring has truly arrived, yet warm enough that I may not need my down jacket anymore. A small seasonal shift can make one notice other kinds of structures in daily life, including those we rarely question.

The trains are crowded after the long weekend. It is slightly uncomfortable, but we tend to accept it by telling ourselves that “everyone is the same.” Yet that phrase deserves scrutiny. When we say “everyone,” we usually mean ordinary workers. But even among workers, there are differences—blue-collar and white-collar, those who commute by train and those who do not. The experience of crowded trains cannot be universalized so easily.

Yesterday was the Emperor’s Birthday. As ordinary citizens, we were granted a public holiday. I remember when the current Emperor was known as Crown Prince Naruhito; having followed the news over the years, I have felt a certain familiarity. And yet, watching the images of the official banquet, I was reminded of the considerable distance that exists.

As children, we wore similar shorts and might have seemed not so different. But seeing the rows of dishes at a state banquet makes one aware of another world entirely—one that continues to exist alongside ours. There are those who stand at its center, and those who support it.

Japan has a world of ceremony and splendor that continues through generations. It exists as a system, sustained not only by tradition but also by cultural and economic structures. There are undoubtedly many people for whom its continuation matters.

Is this disparity, or is it tradition? I am not sure. If it is to endure as an institution, then its place should be clearly articulated in legal and constitutional terms, so that discussion does not drift into emotional reaction alone.

At the same time, we must ask what such an institution is meant to protect. That question is neither simple nor easily answered.