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.

 

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?

 

How to Make the Most of the Natural Fit Between AI and Medicine

 The cold seems to end today, and spring feels close. When I checked the old Japanese calendar, I noticed we are now in Usui—the season when snow turns to rain and the thaw begins.

 

In yesterday’s morning newspaper, I read that part of cytology screening may soon be performed by AI.

My wife, who had read the same article, asked me, “So… will AI take over your work in pathology?”

I told her, “Cytology and surgical pathology aren’t the same, so that’s still some way off. But I can imagine us moving in that direction.”

Fields with a strong morphological component—radiology and pathology, for example—often match what AI does well. When I asked an AI about this, I got an interesting suggestion: pathologists might use AI less to confirm whether the diagnosis is correct and more to check whether anything has been missed in the differential diagnosis.

In oncology, genetic testing has already become central in many settings. If rapid, comprehensive genomic analysis becomes routine, it’s possible that the act of “diagnosing the cancer itself” may no longer require a pathologist in the way it does today. Still, I suspect the final evaluation and judgment—the part that carries responsibility—will remain a human task for quite a while.

Evidence-based medicine has aimed to reduce the personal variability of medical practice and to place scientific evidence at the forefront. In that sense, AI-driven diagnostic support can be seen as an extension of that trajectory.

More areas of medicine may be replaced or reshaped by AI than we currently expect. As personal variability fades, diagnostic processes may become increasingly standardized through algorithms with a certain degree of objectivity. From interviews and test data, AI can generate comprehensive diagnostic candidates and suggest treatment options that are close to optimal.

If that happens, the roles within clinical teams may be reorganized—especially in domains where procedures are not the main work. Even in psychiatry, diagnostic support based on conversation data will likely advance.

As for me, I already rely on AI knowledge as an aid in my diagnostic work more often than I would have imagined a few years ago. It reduces the risk of careless omissions, and that reassurance is real.

Not long ago, a senior pathologist I’m close to said, “Pathology has about twenty years left.” I don’t think he meant that pathology will simply disappear. I think he meant that in twenty years, the technology and the workflow we call “pathology” may look completely different from what we practice today.

In some areas, AI has already surpassed human ability by a wide margin. Even so, AI is still a tool. And how we choose to use it—how we integrate it into our judgment and our responsibility—will shape what each medical field becomes.

An Election Is Not a Vent for Discontent

 The Second Takaichi Cabinet—what some are calling “Takaichi 2.0”—has begun.
With every minister reappointed, the message was unmistakable: continuity, confidence, and freedom from factional compromise.

 

The images of the Prime Minister visiting each parliamentary group were striking. Her expression was confident. The press conference was clear in language and clear in meaning, delivered in a soft and composed tone that left a favorable impression.

The election itself seemed to ask a simple question: “Am I the right person to remain Prime Minister?”
It may have been a straightforward question, but it was an important one. Winning an absolute and stable majority was likely the intended outcome—and it was achieved.

It is said that during this general election, the Liberal Democratic Party refrained from attacking other parties. Instead of speeches that diminish opponents—“Is this really acceptable?”—the focus appeared to be on articulating what they themselves aimed to accomplish.

What can we do?
What are we prepared to take responsibility for?

Without answering those questions, no campaign can succeed. Merely declaring that others are wrong does not expand support. That simple truth seemed to be reaffirmed in this election.

It was, in many ways, a revelation: an election is not a vent for dissatisfaction.

As for myself, I cannot help but ask whether continuing my usual pattern of voting was the right choice.

Still, a result is a result. For now, there is little to do but place expectations on this cabinet. I cannot yet specify what those expectations are. Yet observing the administration quickly propose various policies, one can at least say that it appears willing to act.

At the same time, something else caught my attention. In the footage of meetings with other parliamentary groups, the expressions of centrist politicians seemed tense—perhaps even unsettled.

If they fail to adjust their course, they risk losing their presence as a constructive opposition.

When a governing party is strong, the role of a healthy opposition becomes even more essential.

 

Time Is Filled: Reflections on Deadlines, Density, and the Flow of Work

 With several deadlines approaching and a lecture recording ahead, I find myself thinking less about busyness and more about time itself. We often speak of “having” or “losing” time, as if it were something that could be stored or reclaimed. But perhaps time is never empty to begin with.

 

Last week was taken up by rehearsal presentations, a CPC session, and a research meeting. For the moment, nothing physically binds my schedule, and that brings a certain relief.

Yet three deadlines await me in early March. Beneath the surface calm, the current is already moving quickly.

In daily diagnostic work, the time required for a case can be roughly estimated. A slide under the microscope will eventually yield its answer within a predictable span. Writing, however, resists such measurement. Thought has no clear boundary; one never knows how deep it must go before reaching solid ground.

This time I must also record a thirty-minute lecture for online distribution. The duration is fixed, but the rhythm of speech, the pauses, the tone—these reveal themselves only when spoken aloud. Time, though equal in length, stretches and contracts depending on how it is inhabited.

There is also a revised manuscript to complete. Revision is not merely correction; it is the act of placing one’s present self beside one’s past words. Tools—especially intelligent ones—may assist. Yet if thinking itself is delegated, the outline of the thinker gradually fades.

How much time should be given to each task? One may try to calculate, but in the end decisions seem to settle within the flow itself.

Come to think of it, time is always filled.

Time spent diagnosing.
Time spent writing.
Time spent traveling.
Time spent sleeping.

Even what appears empty is occupied by something—attention, memory, anticipation, fatigue. Time neither overflows nor runs dry. It cannot be stored for later, nor borrowed in advance.

The only freedom we possess is to decide what shall inhabit the present moment.

Time itself has no density. Density is given by what we place within it—our thought, our action, our intention.

The current moves on, steady and indifferent. Meaning does not arise from time. It arises from how we dwell within it.

Time is already filled.

What remains is to choose its contents.

And so, I return to my work.

Two Skaters Who Believed in Themselves and Saw It Through

At the Milano Cortina 2026 Japan’s pair skating team known as “RikuRyu” — Riku Miura and Ryuichi Kihara — overcame a short program setback to capture the gold medal.　What stood out most was not simply the comeback, but the quiet strength of two athletes who trusted their own work until the very end.

 

I had heard their free skate would begin around six in the morning, so I woke up a little early and waited while getting ready for the day.
Just as I started brewing coffee, their program began.

Even through the television screen, the beauty and completeness of their skating were unmistakable.
It was refined, composed, and deeply controlled.
Before long, I was no longer thinking about rankings. I was simply absorbed.

The pairs who followed were also excellent.
Yet none reached the level “RikuRyu” had just shown.

The Olympic stage is often described as a place inhabited by demons — where even overwhelming strength can be undone by the smallest mistake.
And yet they delivered an almost flawless free skate and achieved a dramatic comeback.

With five pairs ahead of them, it would have been natural to feel the gold medal slipping away.
Perhaps they stopped thinking about standings altogether and focused only on skating the program they had worked toward for years.

“Results will follow.”
Maybe that was their mindset.

But it was not resignation.
It was simply belief — belief in the strength they had built through steady effort.

In recent years, I have found myself less easily moved by sports.
But today was different.
My wife and I both found ourselves quietly in tears.

After the short program, I remember how Miura gently comforted Kihara.
Yet what stayed with me even more was the moment after their victory was confirmed — Kihara in tears, and Miura looking at him with a small, slightly exasperated smile, as if to say, “What am I going to do with you?”

Knowing the long struggles Kihara has endured, that scene made me especially happy.

Congratulations, RikuRyu.
And thank you for the inspiration.

Many Kinds of “Cancer” — On International Childhood Cancer Day

Watching the news the other day, I noticed several reports about cancer.
One of them focused on International Childhood Cancer Day.

It reminded me not only of the statistics and medical progress we speak about today, but also of a memory from my own childhood—when I first heard a word I did not yet understand: “brain tumor.”

 

While watching the news on NHK, I noticed several topics related to cancer. One of them was International Childhood Cancer Day.

Childhood cancer refers to malignant tumors that occur in children under the age of 15. These include hematologic diseases such as leukemia, as well as solid tumors arising in the brain, adrenal glands, reproductive organs, and other sites. In Japan, approximately 2,000 children are diagnosed each year.

I still remember a classmate from my first year of elementary school. During recess, he suddenly developed a nosebleed in front of us. He was later diagnosed with a brain tumor and eventually passed away.

It was the first time I heard the word “no-shuyo”—brain tumor. At the time, I had no real understanding of what it meant.

International Childhood Cancer Day aims to raise public awareness about childhood cancer.

Adults, to some extent, can seek medical care on their own and participate in decisions about treatment. Children cannot. After onset, they can do nothing by themselves. Some are too young even to understand their illness. That is why the burden on parents is so heavy, and why society as a whole must support both patients and their families.

I have spent decades working as a pediatric pathologist.

Today, I understand that the word I once heard as “no-shuyo” meant “brain tumor,” and that this single term encompasses many different types of neoplasms.

Like adult cancers, pediatric cancers are remarkably diverse. Yet each individual tumor type is rare. Some are so uncommon that one might encounter them only once in a lifetime.

Diversity and rarity coexist—an almost paradoxical world.

Pediatric oncologists must study continuously in order to tailor treatment to each individual case. Watching their dedication, I cannot help but feel deep respect.

Children should live longer than adults. Protecting that time is, I believe, our responsibility as adults.

Meanwhile, according to a summary released by Ministry of Health, Labour and Welfare, five-year survival rates for patients diagnosed with cancer in 2018 have improved for pancreatic cancer, multiple myeloma, and lung cancer among those aged 15 and older.

Pancreatic cancer, in particular, remains one of the most aggressive malignancies. A friend of mine, the same age as I am, lost his life to it. Despite therapeutic advances, cancer remains a serious and deeply personal disease.

Cancer is a condition in which part of one’s own body chooses an independent path of growth. It is difficult to prevent entirely.

Traditionally, surgical removal has been the primary approach. Today, however, targeted therapies and immunotherapies are increasingly capable of attacking tumors at the molecular level.

Alongside rapid advances in artificial intelligence, both diagnosis and treatment will likely change dramatically in the years ahead.

As pediatric pathologists, we too must make use of AI-assisted diagnostics and continue seeking better, more clinically meaningful diagnoses that truly benefit patients.

Is February a Week Shorter This Year?

 A warm and gentle day in Kamakura.
My younger brother’s 49th-day memorial service was held at a local cemetery.
A small coincidence, a crowded street, and a rumor about February being “one week shorter” — all somehow part of the same day.

 

It was an unusually warm day.

My younger brother’s 49th-day memorial service was held at a cemetery here in Kamakura.

Had it been one week earlier, we would have been caught in heavy snow. We were fortunate. Some coincidences are best received quietly, without overthinking them.

After the service, we gathered for a meal at a Chinese restaurant near Komachi Street. Walking through the shopping district, we found it as crowded as ever.

The news has been reporting a sharp decline in Chinese tourists during the Lunar New Year, suggesting that local businesses are struggling. Yet, from what I could see, the number of visitors felt almost just right. People still come. They always do.

Lately, I had the odd impression that this February was passing unusually quickly. Then I heard a rumor—apparently, a “rare phenomenon not seen in 851 years” was occurring this month. It was even mentioned on the radio yesterday.

So that must be it, I thought.

February is one week shorter this year.

Wait.

That cannot be true. February still has 28 days. Losing three days would be one thing—but an entire week?

It turned out to be nothing more than a trick of the calendar. This year, February 1 falls on a Sunday and the 28th on a Saturday. The final row of the monthly calendar is left blank.

That empty row creates the illusion of a shorter month.

And as for the “once in 800 years” phenomenon? Apparently, it happens every decade or so.

One might say those who believe such rumors deserve to be fooled. Still, I have to admit—it was a rather well-crafted joke.

 

Sleep-Deprived at a Web Conference

 After a small research meeting in Tokyo and a late dinner with colleagues, I returned home to Kamakura close to midnight.
Even when the train connections are smooth, Kamakura still feels far away at night.

I took a bath and fell asleep without difficulty. But around three in the morning, I woke up.

I remembered that the finals of the snowboarding and figure skating events were on, so I turned on the television. I drifted in and out of sleep, switching the TV on and off, never quite reaching deep rest. Morning arrived before I knew it.

Ironically, I missed most of the crucial moments in both events.

I would have liked to go back to sleep, but I had a web conference scheduled. So I stayed up and carried out my role as co-presenter and chair.

It was educational, as always. Still, with so little sleep, some parts did not quite settle into my mind.

I am sensitive to the cold and not particularly interested in winter sports. The Winter Olympics do not usually capture my attention. Yet once they begin, I find myself watching anyway.

There is something undeniably moving about young people giving their all.

At the web conference as well, younger colleagues were presenting. Watching them, I felt reassured about the future.

Even through sleepy eyes, it is encouraging to see the next generation steadily stepping forward.

 

A 65-Point CPC

 At yesterday’s CPC, I would give my own presentation 65 points out of 100.
It may have been useful in part, but it certainly was not an “A.”

 

At yesterday’s clinicopathological conference (CPC), I would score my own presentation at 65 points.

Some aspects may have been helpful to those in attendance, but it was not something that deserved an A.

From a pathology standpoint, I had done what I could.
But that alone was not enough.

In particular, my differential diagnosis was not thorough enough.
I could explain the mechanism of death, but I did not fully pursue the deeper question: What ultimately caused that mechanism to occur? That is what still lingers with me.

These days, it is not unusual for audience members to search online in real time and fire off sharp questions based on what they find. It can be daunting.

I would like to do the same myself, but standing before a room full of people, that is not always possible.

Perhaps next time I should consider going fully online, where adapting in real time might be easier.

And yet, there is something deeply gratifying about seeing a large conference room filled with people.

It is not simply about speaking in front of a crowd. What moves me is that so many people gather for a conference organized by pathology. It reminds me that our field still holds weight within the hospital. It makes me feel that I must keep pushing forward.

With the Olympics underway, athletes often say, “I did everything I could.”

But doing what you are capable of is only the starting point. One must search for what more is required.

Athletes who fall short likely do so because something essential was missing—and they know it. That is why defeat brings tears.

Whether it is my presentation or the Olympic stage, neglecting what truly needs to be done leads to the same result: regret.

And this applies to all work.

Only by mastering those necessary steps does one become a true winner. Effort earns respect precisely because it confronts what must be done.

Reaching that level is difficult. And even if one arrives there, a steeper and longer road awaits.

That is life.

A Day of Controlled Chaos

 Some days feel overwhelmingly busy—though I am never quite comfortable with the word “busy.” Perhaps it is more accurate to say that work is simply piling up.

 

Today is one of those days.

Even “overwhelming” may be an exaggeration. After all, I still have the luxury of writing this short post. So perhaps it is merely a moderately full day.

Gross examination in the morning.
Microscopic review in between.
And tonight, a CPC—Clinicopathological Conference.

I should have prepared a bit more for the CPC yesterday. Instead, I was drawn into rearranging furniture at home—well, to be precise, participating in what might better be described as an early spring cleaning. As a result, my preparation was less thorough than I would have liked. I will have to review things in the gaps between tasks.

So, I will keep today’s entry short.

Wherever you are, I hope you can spend the day calmly and without irritation. Life is lived only once. Rather than constantly adjusting our emotional tempo, perhaps it is best to remain steady—just as we are.

Is It Time to Rethink Our Electoral System in the Age of Social Media?

 Whether it is a blog, Instagram, or any other platform, we all “follow” someone. But on what basis do we choose whom to follow? As social media increasingly shapes not only our personal tastes but also our political perceptions, I sometimes wonder what this means for democracy itself.

 

Whether it is a blog, Instagram, or anything else, how do we decide whom to add to our “favorites” or follow on social media?

Do we choose people whose sensibilities and ways of thinking resemble our own—those who post articles or photos that feel familiar to us?

Or do we simply follow accounts that offer beautiful images or well-crafted writing for us to enjoy?

Perhaps it is a mixture of all these reasons. Still, it is a curious phenomenon.

The systems of “favorites” and “follows” appeared roughly twenty years ago. Before long, they became an ordinary part of daily life. Today, people compete over follower counts, and large numbers can even translate into income.

There have long been writers who put their articles behind paywalls. I stopped reading one blog when it suddenly became paid content. I did not feel the writing was worth paying for. It never returned to open access, yet it must still have enough supporters to sustain itself.

Information, in the end, may simply gather among like-minded people. We enclose ourselves within circles that resemble us.

Recently, the use of social media in election campaigns has also become commonplace.

On trains, I often see young people scrolling through YouTube at remarkable speed. I sometimes wonder whether they consume political campaign messages in the same way—quickly, selectively, and within the confines of algorithms.

Just as with blog followers, once someone feels aligned with a particular politician, more and more of that politician’s information flows toward them, while opportunities to encounter different views diminish. Could this be happening already?

It is a little unsettling.

Politicians are rarely professional writers. Yet if they hire skilled bloggers or media professionals to craft their websites, it is entirely possible to construct an attractive and persuasive political persona. Inevitably, some people will be drawn in.

Opportunities to meet politicians directly, to listen in person, and to judge with one’s own eyes are steadily decreasing.

If, as in the most recent general election in Japan, the future of the country can be shaped largely by the popularity of a single political figure, that may be slightly precarious.

Perhaps our electoral system itself—designed for a different era—has reached a point where it deserves reconsideration.

Hoping Our Elected Leaders Will Grow Into Respected Adults

 After weeks of lingering cold even past the start of spring, signs of warmer days are finally beginning to appear. As winter loosens its grip, the political climate, too, has entered a new phase—one that demands patience, restraint, and a sense of responsibility from those who now hold power.

With its overwhelming victory, Prime Minister Takaichi’s Liberal Democratic Party now has four full years to pursue the policies it envisions.

From this point on, whatever course the Takaichi administration chooses must be accepted as the outcome of a democratic process. This is true not only for those who actively supported the ruling party, but also for the nation as a whole, which ultimately produced this result. There is no avoiding that reality.

It is much the same as in the United States, where voters chose Donald Trump and then committed themselves to living with that decision for four years.

Political policies span the spectrum from right to left, and no government can ever satisfy everyone. Still, one can hope for a form of governance that allows as many people as possible to live with a sense of well-being.

Just as important is a genuine effort to dismantle politics driven by vested interests and corruption. Some lawmakers involved in illicit funding may well continue to seek personal gain by any means available. Yet Prime Minister Takaichi’s statement that “this issue is far from resolved” offers at least a small measure of hope.

In today’s society, truly respectable adults seem to be in short supply.

All I can do is hope that each newly elected representative conducts their political work with integrity and transparency, and grows into the kind of adult worthy of public trust.
Politicians who fail to do so should never be forgiven.

 

Japan’s General Election: A Landslide Victory for the Ruling LDP, but Turnout Below 60%

Japan’s recent general election ended in a sweeping victory for the ruling Liberal Democratic Party (LDP), effectively reaffirming Prime Minister Sanae Takaichi’s leadership. While the result brought political clarity, the low voter turnout raises a more uncomfortable question: how many citizens are truly participating in shaping the country’s future?

 

The confidence election for Prime Minister Takaichi concluded with an overwhelming result: the Liberal Democratic Party, Japan’s long-standing ruling party, secured 316 seats on its own—well over a two-thirds majority in the lower house.

In the United States, when voters choose a president—even one who quickly embarks on aggressive policies—there seems to be a shared resolve to accept that choice and live with it for four years. After this election, it feels as though we in Japan are now required to show a similar kind of resolve.

Watching the election coverage last night, it was hard not to feel sympathy for lawmakers from the former Constitutional Democratic Party. Many appeared to fall one after another, paying the price for strategic failures at the leadership level. When defeat reaches such a devastating scale, however, one cannot help but wonder whether the party itself can survive.

Still, a result is a result.

An effective “all-ruling-party” situation is not without its risks, but this is neither military rule nor dictatorship. In that sense, perhaps it can be accepted for what it is.

That said, the prospect of a return to the LDP’s old patterns—collusion, corruption, and money-driven politics—is deeply dispiriting. Even so, there is room to hope that Prime Minister Takaichi, with her relatively clean public image, can prevent the worst of these tendencies from resurfacing.

What lingers most strongly, however, is the voter turnout. It was reportedly around 55 percent.

Whether one votes or not is, of course, a matter of personal freedom. Perhaps the roughly 40 percent who stayed home feel satisfied with that choice.

They probably are.

But when the prime minister speaks of issues that divide the nation, it is worth remembering this: if those same citizens continue to stay away from public debate—and from future referendums—the country may end up moving in directions they never intended.

Or is it enough, after all, for the will of just 55 percent of the electorate to determine the nation’s course?

A Sense of Unease While Watching the Winter Olympics

The snowfall from the previous night stopped by morning, and I was able to attend the second day of the conference without trouble. The forecast—about five centimeters of snow—was accurate, and the day turned out to be bitterly cold.

Watching the Winter Olympics in such weather, I found myself noticing something that had bothered me before, but never quite this strongly.

 

Participation by non-white athletes in the Winter Olympics appears strikingly limited.

I had been aware of this for some time, but it stood out more clearly this time than ever before.

Perhaps this is because the recent Games were held in South Korea in 2018 and China in 2022, and this is the first time in a while that the event has returned to a predominantly white host country. The medal ceremonies, the athletes on the podium, even the women presenting the medals—all appeared overwhelmingly white.

Without host-nation quotas, the number of East Asian athletes is visibly smaller. I did not watch every moment of the opening parade, so I cannot say how many Black athletes participated, but in the glimpses I saw, there seemed to be very few.

Of course, people of diverse backgrounds could be seen in various supporting roles, but proportionally, that may simply reflect the nature of the event.

Winter sports are expensive by definition, and in that sense this imbalance may be inevitable. Skiing, skating, and sledding began as leisure activities and have been refined into highly specialized competitive sports. The effort and ingenuity behind that evolution are remarkable.

Still, when I look at the faces and skin tones filling the screen, I cannot help but feel a lingering sense of unease.

 

How Big Can Events Keep Growing?

 On a morning bound for an academic conference in Tokyo, I found myself watching the opening ceremony of the Milano–Cortina Winter Olympics over breakfast.
I left home before the Olympic flame was lit—aware that staying any longer would mean arriving late. Snow was forecast for the evening, and I was already wondering how I would get home. At the very least, I decided, I would pay the reception fee and leave early.

Watching large-scale events like the Olympics, I cannot help thinking about the sheer difficulty of running them.

Of course, these events are handled by professionals. Still, professionalism does not make things simple. Opening ceremonies can be planned down to the minute, but the actual competitions must contend with weather and uncertainty. The logistical burden is immense.

While the dedication of the athletes naturally draws attention, the people who support the event—quietly, efficiently, and often invisibly—deserve equal respect. It is work, yes, but work of a very demanding kind.

The same question arises when I think about academic conferences, whether those I attend or those I have organized myself. Why do such events almost inevitably grow larger over time?

Last year, I intended to keep things at roughly the same scale as the year before. Whether I succeeded is another matter; perceptions from the outside may have been quite different.

The Olympics face a similar dilemma. In theory, one could strip them down to something simpler, more restrained. In reality, that never seems to happen. Even academic meetings could probably function without elaborate social gatherings.

As I watched the opening ceremony, I found myself wondering how long we can continue to sustain events of this scale. At the same time, I began to think more seriously about the conferences I will soon be responsible for—and how large they truly need to be.

When a Mentor’s Words Suddenly Come to Mind

 While making a pathological diagnosis, certain phrases unexpectedly surface in my mind—words once spoken by mentors who taught me how to see, think, and decide. It feels a bit like a flashback scene in a TV drama, appearing without warning, yet at exactly the right moment.

 

When I am working on a pathological diagnosis, various words from teachers I would call mentors sometimes pass through my mind.

The feeling is similar to those sudden flashback scenes in television dramas or manga, where memories appear unannounced in the protagonist’s thoughts.

Some of these phrases are not original to a particular teacher but are well known among pathologists. A representative example is: “Always look at a specimen believing that there must be a finding.”
But there are many other words that also come to mind.

Over the years, I have been taught pathology and research by many pathologists. With each of these mentors came countless exchanges of words, many of which have become part of my blood and bones as a pathologist.

In fact, I wrote down only the title of this article after noticing this phenomenon during a diagnosis. However, I have since forgotten which case it was, which mentor it involved, and exactly which words came to mind.

Even as I write this now, I cannot quite remember.

It is an interesting thing.

Perhaps, during diagnosis, the brain is operating close to its limits—fully engaged, gathering every possible piece of information, including the voices of mentors. That may be why certain words emerge seemingly from nowhere.

The fact that I cannot recall them now may mean that I am relaxed, or that a different part of my brain—separate from the one used for pathological diagnosis—is currently at work. In that state, my mentors’ words may simply have no role to play.

We often describe AI thinking in terms of neural networks. Reading this back, I find myself oddly convinced that my own brain is doing much the same.

When Small Things Start to Irritate Me

 Lately, I find myself getting irritated over things that shouldn’t matter.
I know they are trivial. I know they will pass.
And yet, the irritation lingers, and I can’t quite explain why.

 

These days, I get irritated by small things more often than I used to.

I’m not sure why.
It could be the sheer volume of work, the constant noise of an upcoming general election with the same faces and voices repeated every day, or simply the cold weather. 

I honestly don’t know.

Poor manners on trains or careless driving are typical examples.
There is no point in getting upset over them, and I know that.
But once I start noticing such things, the irritation gradually builds.

Even if I say something, it will likely be ignored.
After all, they are strangers, and it is none of my business.
I should just let that moment pass. Getting angry serves no purpose.

If I could truly think, “People are people,” I should be able to let it go.
Yet somehow, I can’t.

They are not invading my personal space or disrupting my life in any real way.
They are simply doing something that catches my attention at the edge of my vision.
It isn’t illegal. It isn’t forbidden. In principle, they are free to do as they like.

As I write this, I keep asking myself why, again and again.
But the answer doesn’t come easily.

Thoughts and emotions always have their roots within oneself.
And yet, I cannot clearly identify the pattern behind this irritation.

I know that somewhere deep down, there is an idea of how people “should” behave.
I also know that I am not free from hypocrisy, judging others while overlooking myself.

Even so, the question remains:
Why do I get so irritated over such trivial things?

At the very least, I know this much.
Such feelings are unproductive and can become a burden not only to myself but also to those around me.
So for now, I will try to be more conscious of my words and actions.

Speaking Freely Is Also a Way of Living

 In politics, speech can be a double-edged sword.
Words that come too quickly may unsettle markets and people alike, while words that are weighed too carefully can leave a country frozen in place.

Watching political leaders today, I find myself wondering where the balance truly lies—and how that question reflects not only on governments, but on the way each of us chooses to live and speak.

 

 

What should we expect from political speech?
Carefully deliberated statements, or words delivered decisively, even at the risk of controversy?

Too much deliberation can turn leaders into statues—immobile, silent, and ineffective.
Too little, and words alone can send people, markets, and entire systems into confusion.
In fields like finance or national defense, either extreme can be dangerous. Yet there is no rule that says leadership must choose only one approach.

Ultimately, voters decide what kind of leadership they accept—and must live with the consequences of that choice.

Looking at the current U.S. administration under Donald Trump, it is not always clear which side it falls on.
Policy announcements appear rapid and relentless, but they may still be the product of careful calculation. Or perhaps, in moments of national decision-making, clarity and speed matter more than exhaustive deliberation.

Similar questions arise elsewhere.
Japan’s Prime Minister Sanae Takaichihas made remarks on Taiwan and currency policy that stirred debate. These comments likely rest on her long-held views, even if they strike listeners as abrupt.

Thinking about this brings me back to myself.

When I was younger, I spoke too freely.
That made me seem amusing to some—and deeply offensive to others.
Even now, I occasionally regret words that escape before reflection has caught up. I remind myself often to be more careful.

And yet, when I look honestly at my own habits, I realize something: the words that slip out most easily are not random. They reflect, in the end, my underlying view of life.

I tend not to overthink.
I speak what I believe, openly and directly.
If that is called being “loose-tongued,” then so be it. It is simply how I live, and it is not easily changed.

This blog is no different.
I write here every day, recording whatever comes to mind. There is no grand theory behind it.
For academic papers or conference presentations, I choose my words carefully and deliberately. This space serves another purpose.

In an age where blogs, conversations, and social media blur into one continuous stream of speech, the distinction may not matter much anyway.

Whether this article is right or wrong is beside the point.
Thinking, writing, and speaking daily—this too is part of my way of living.

One difference remains: blog posts can be revised.
Everyday conversation cannot.

That is something I should probably keep in mind.

Kindness Is Never Wasted

I had been struggling with the selection of speakers for an academic meeting.
After finally consulting a senior colleague, the situation now seems likely to be resolved.

Perhaps I should have asked for advice earlier.
Still, having wrestled with the problem on my own made me appreciate the help all the more.

 

I am regularly invited to give talks as a guest speaker at several study meetings.

There are certainly many people who are far more capable than I am, and who know much more than I do.
And yet, I continue to be invited.

I am not entirely sure how useful I am to others, but for my part, I learn something every time.
For that, I am deeply grateful.

Of course, the help I receive is not limited to my professional life.
At many moments and in many situations, I am supported by different people.

I recently wrote an article saying something like, “I am who I am thanks to everyone around me.”
The fact that I find myself writing about the same thing again today suggests that I may have begun to forget that gratitude, even if only a little.

I need to be careful.

There is a Japanese saying that kindness is never for the benefit of the recipient alone.
I hope that I, too, can remain—however modestly—within that ongoing cycle of kindness.

A Week of Mental Pause

 

Yesterday, I cast my early vote.
From that moment on, my single choice was sealed inside a ballot box for a week—out of reach, and out of my hands. 

 

Yesterday, I completed my early voting.
My single vote for the future government was locked away in the ballot box, where it will remain for a week.

Once that happens, my actions can no longer influence the outcome.
And with that realization, my interest in the election itself drops sharply.

The morning news I usually keep on as a kind of clock has now been replaced by campaign broadcasts.
Until last week, I let them play in the background without much thought.
This morning, I turned them off and switched instead to the noisy, restless chatter of commercial TV news.

The forecasts suggest a victory for the Liberal Democratic Party and Ishin, along with continued struggles for the political center.
That seems about right.

From here on, I will be extremely busy for a while.
I do not have the time—or the mental space—to dwell on politics.
Instead, I will use that time for myself.

Today, the first task is simple:
making a to-do list.

The Present, Where Past and Future Meet — Plans Still Undecided

Time moves on, whether we are ready or not.
As memories quietly compress into the past and the future remains uncertain, all that truly exists is the present — fleeting, fragile, and strangely powerful.

 

It is already February.

Time moves quickly again this year.

The fact that my younger brother passed away in December feels like something from the distant past.
The same is true of my trip to New York over the year-end holidays.

January was full of events, but in the end, all of them have been compressed into the past, leaving only the present.

Yes, the past exists as the past, the present exists as the present, and ahead of us lies only the future.
The point where they meet is the present — and in the very next moment, that present becomes part of the past.

Today, I went to cast my early vote.

My future is sealed inside the ballot box, yet that future will not be revealed until a week from now.
Situations like this occur from time to time in the world.

Even when we make plans for the future, those plans remain, by definition, undecided.
When I stop and think about it, it is a rather curious thing.

Perhaps only humans reflect on such matters.

Other animals likely spend little time thinking about the future — or do they?
If only I could ask them.

In any case, enough pondering.
Tomorrow, it is time to return to work and do my best once again.