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.

 

At Last, the Olympics Are Over

 The Milano–Cortina Winter Olympics have finally come to an end. Watching the endless white landscapes and navigating the complexities of judged events left me more fatigued than exhilarated. And yet, amid the confusion and skepticism, there were moments that quietly moved me.

The repetition of snow-covered scenery eventually became overwhelming. Most events were individual competitions, and many were judged sports whose scoring systems were difficult to grasp. Often, it was only after commentators explained the results that I understood what had happened. That, perhaps, diminished some of the excitement.

 

In the past, ski jumping seemed simpler. Distance mattered most. Athletes like Matti Nykänen flew without fuss over style points. Now, sports like snowboarding—astonishing as they are—unfold in sequences of movements almost beyond imagination. Rotations are counted in multiples of 180 degrees, but trying to calculate them in real time while listening to the announcer is a losing battle.

Still, figure skating brought genuine emotion. Seeing Riku Miura and Ryuichi Kihara in tears moved me more than I expected. Even watching the highlights later, I found myself quietly tearing up again.

Akito Watabe’s final run in Nordic combined was also memorable, though the trouble he encountered was unfortunate. The discipline itself is said to be facing an existential crisis. If popularity becomes the sole criterion for survival, what will happen to traditional events? Once removed, revival is unlikely.

For young athletes who have devoted their lives to sport, the difference between winning a medal and falling short can shape the course of their futures. I am not entirely sure whether sport carries such intrinsic value. Yet a life committed so fully to a single pursuit deserves respect.

To those who earned medals, and to those who did not—well done.

 

Early Spring, Already? — A February Wind in Kamakura

 A strong southern wind swept through Kamakura today. While western Japan has already officially declared the first spring wind, Kanto is still waiting. Yet the air already feels like spring.

 

In Kamakura, a strong southern wind was blowing, and my wife and I wondered if it might be the season’s first spring wind. News reports said that Kyushu and the Chugoku–Shikoku regions had already officially declared haru ichiban, the first spring gale of the year. Apparently, the designation depends on the meteorological observatory. When will it be Kanto’s turn?

If it blows again tomorrow, perhaps that will settle it.

Still, it is only February, and yet it already feels unmistakably warm. This mild air seems to have spread across the country. In northern regions, the rapid snowmelt must be causing its own difficulties.

More than the first spring wind, what concerns me is pollen. Cedar pollen is said to peak about a month from now. The thought is slightly depressing.

It was a warm holiday weekend.
A walk with Anne.
A bit of gardening.
A day that felt like borrowing time from a later season.

Or perhaps this is no borrowed warmth at all.
Perhaps late February has simply become this way.

Is Japan Becoming Poorer?

 Though spring has been said to be arriving, the warmth hasn’t fully come yet. On a recent walk, I didn’t even need my down jacket—just a leather jacket was enough. Yet, as I took in the mild weather, my mind kept drifting back to news about Japan’s economic challenges. It made me wonder: are we really becoming poorer as a nation?

 

The other day, I read that a U.S. Federal Court ruled former President Trump’s tariff policy was beyond the scope of presidential authority. How this decision will affect Japan is still unclear, but it seems inevitable that we will push forward with massive investments—perhaps as much as ¥80 trillion—to respond to global economic shifts.

Last night, I saw a report stating that the real value of the yen has fallen to one-third of its peak. That was discouraging to hear. When the currency weakens, the cost of imports rises, squeezing everyday life. At the same time, individual assets—once thought to be enough to cover the nation’s debt—are also losing value in real terms. The thought that we might be “stripped even further” in an already difficult situation brought a quiet sadness.

For a long time, I believed Japan was still a wealthy country. But when I consider the lived experience of ordinary people—the hidden inflation, the pressures on savings and investment—it feels like that assumption may no longer hold.

Is Japan truly becoming poorer? Or are we simply confronting deeper structural challenges that we have ignored for too long?