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Hello, today is June 17, and it is currently 1pm. I'm Christine Wu with the Houston Asian American Archive, and I'm here today interviewing Dr. Tetsuo Ashizawa, also known as Tee, who is a

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physician and scientist focused on- focusing on neuromuscular medicine and neurology, and he is board certified by the American Board of Psychiatry and Neurology. He also serves on multiple grant review panels, including NIH study sections, as well as was the executive director of the McKnight

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Brain Institute in the University of Florida, and worked at the University of Texas Medical branch and the University of Florida. Thank you for joining us for an interview today.

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You're welcome, Christine. I'm looking forward to this interview. Perfect. So first, we're gonna start off with a little-a few questions about your earlier experiences before you came to the United States.

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So where and when were you born? I was born in Tokyo. And on September 11, actually, in 1948- it's, uh, three years after the end of

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the war. Did you stay there in Tokyo or did you move around Japan when you were a child? No, I was- I was in Tokyo for- well, within Tokyo, we moved a couple of times. But essentially,

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that was my activity area. I went to school in the next prefecture in high school and college. That's Kanagawa Prefecture next to Tokyo.

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So how would you describe the household you grew up in? And were they influential in helping you choose medicine as a career path? That's a long story. So when I was growing up,

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we were all very, very poor. And it's post war, so we had hardly enough to eat. And, you know, I remember that I was told

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to cook this fish. And the fish is-just only one fish, about this big . And we are using that charcoal, and I was using a fan.

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And then our cat came, took it away, and that was the only thing that we can eat with rice. So that night, we didn't have anything else but rice. But rice itself is a luxury, white rice was a

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luxury. So what-I used-vividly remember that instance, and my mother was not very happy, and then she scolded me, “Next time, you have to watch for cat”. And so you know, I think-but if you're looking

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back, everybody was poor, essentially, there are not much wealth, and there are not many materials sold, and we didn't earn any money to begin with. But even if you had, it's difficult to find, and

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I remember- I have a three year old-three year older sister, as old, you know, she's-she's, older three, three years more than I was. And so she of course had clothes, but I've never had new clothes.

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And my mother used the materials, cloth material of my sister's clothes and take it apart and made my clothes. So I had flowers on the pants and that kind of stuff.

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And it's quite eclectic and those patches, yeah, those are-those are standard. And we had shoes, actually. And that was a good thing. But so that's my early childhood. But it was very peaceful because war was over three years before

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I was born. And the surrounding area was quite pastoral and, you know, lots of nature and the rice field and other things. So my pastime as a child was playing with my sister and some other little kids, but by

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going to-you know, there are a bunch of ponds, the ponds were-the water filled, uh, filling the bomb crater. Because close to my home, there was a manufacturer of the aircraft by the government.

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I mean, that's-later on it became Nissan, you know, you know, the car company. So B-29 bomber for how of American Air Force dropped a lot of bombs. And we had a lot of craters, and the water filled and

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somehow, with-Americans, American crawfish came. So it's a crawfish that you're gonna eat, you know, it just goes backwards.

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And but, uh, the way we fished was very interesting. We had what's called surume, s-u-r-u-m-e, that's dried squid, and you put the dried squid on the string and

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have a fishing pole, and then throw it in. And then those crawfish will, with pincer, they hang on and try to eat, and we can pull it out. And by the end of the day, you can have a bucket full of crawfish.

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Now so, shamefully we played with them, but we never ate it because at that time, Japanese people didn't know how to eat crawfish. So retrospectively it would be a good feast.

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Wow. So it seems like you were very resourceful as a family growing up. Was that one of the values that they tried to instill in you growing up? And what were some other values? Well, you know, I think it's always-that core thing

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is, cherish peace. And so the peace was so valuable to my parents. Of course, I didn't know anything about war.

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But, you know, ever-since everybody else was poor, we didn't feel that we were poor, we are the average. And our happiness is

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really remarkable. You know, decades later, I was talking to my mother. Now we have cars and, you know, television and refrigerator, air conditioning, etc, etc. And we-our standard of living is much better.

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Then you know, we talked about, well, but you know, all those old days are really real happy. And, you know, much better than now.

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It's sort of ironic. You know, I think my family's value is not revolved around materials, or money. But it's peace and happiness, and families helping

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each other. That was the most valuable thing. That's very insightful. Do you think-how would you describe the neighborhood you grew up in? Do you think they also had similar values?

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And do you think that the neighborhood shaped you, what was, like, that like? Well, it is a little bit different story because postwar Japan as you know, there was a economical miracle they called, and prosperity happened.

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But during the prosperity, of course, it's cannibalism, so to speak, you know, as the strong will exploit the weak and take advantage and start seeing that trend of the

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rich becomes richer, and the poor becomes poor, and losers and winners. And so later on, it becomes more and more so and became sort of uncomfortable. But fortunately, my family is

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typical middle class, also, standard of living is not that great, at that time. So we were happy, and that in my neighborhood, the majority of people are modest people, and very

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similar to our household. The father works in the company, and mother is a housewife, and two or three kids, and- and making a living.

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Nothing lavish, nothing really dead poor. So we were very happy-in a way that was, uh, so to speak, you know, ideal society. But still, there are lots of problem in the

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society. Still, tuberculosis is one of the major perils, and people died from those. And so it's not that-as good as current standard but that happiness was- it was

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very interesting. Thank you for that insight. You mentioned that tuberculosis was widespread at the time. Did that have anything to do with your choice to go into medicine? How did that impact your life?

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Well, yes and no. So we-all got, uh, what is it called, BCG, I think you may have heard of it as a immunization against tuberculosis.

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And so tuberculosis went down, also antibiotics and that tuberculosis drugs were quite-quite effective. So by the time I was in my teens, tuberculosis subsided, and so I clearly

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remember those, uh, those medical threats. And also when we went to train station, that GIs of American occupation army, what they did was they have this little pushing pump type of thing, and that will create

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powder of DDT. That's a insecticide-because we were infested with lice, you know, fleas and that kind of stuff. So that spreads disease, so that diseases, right, I mean, we grew up with

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those, uh, threat of the disease-diseases. And so that influenced, to some extent, but that was not my direct motivation to become a physician. Okay, thank you for that story.

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Um, I also have a few questions about-what were your parents occupations, was-you said that most people were-the wives were housewives and the husbands went to the factory, where did your father work? So my father was-in Japan, they call it "salary

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man". That means you go to work and get envelope of money, and come-come back once a month with money. And he was working on, earlier, the mining

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company, but he was office worker, and then later on he was working for, it's this Mitsubishi industry company. And, but he has never gone to, really the executive position, he went barely to low

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management position. There's a story behind it, because he was anti-social, maybe, to some extent, uh, you know, the extent-in Japanese standard in that era,

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he may be a little bit of a sociopath. The reason why I say, I think he was a good man in my mind, and he has a high standard of morals, uh morals. And but when he was in elementary school,

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in his essay, he questioned the authority of the Emperor. Okay, and it was pre-war, you know, militarism was very high in the place.

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So uh, he wrote- what he wrote was, it's in Japanese saying that "even fish head, if you worship it, it becomes valuable", appear to be valuable, actually.

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So he wrote that in, I think he was in fifth grade, wrote that in the essay. So from then on, he was marked, black marked in every single report, and particularly those military officer comes to school and train school students for the military

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exercise. I mean, they really singled him out. And so he became even more anti-social, because he hated those people. And then, so he was drafted. And he-he actually went, graduated from a very good school

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and college. It was, I think he was top 2-3 percentile in the school when he graduated, but he refused when that war started-he refused to, what do you call in English,

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become a-become an officer? That's, uh, yeah, so the college graduates are recruited to become an officer. And he refused. So he went to Manchuria, as a-as a private and

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then there, he was talking to a lot of people, but his medical officer in the military-identified that he is not the, you know, he was the only man but he-he's smart.

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He was well read, so he said, "Ashizawa, you need to go back to Japan". So he wrote the report of a chest X ray, there was a shadow and the tuberculosis, honorable discharge, so

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he was very indebted to that doctor, military officer. So, you know, I think that, uh, was interesting consequences.

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He never became very high-ranking in the society, even in the company. So he retired and he was not earning too much money. So when I went to college, and I went to private

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college called Keio and that's a fairly expensive school. So they really squeezed money out of that little envelope that he brings back every month. So I was, I

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appreciated it very much. Luckily, my mother's father, you know, my grandf-maternal grandfather, was quite successful, so he helped me and my sister.

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So the reason why I went to medical school is not because of those story related to medicine. But when I was in high school, I started getting very interested in science, particularly biology.

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And in high school, I went to university biology lab, and dealt with the fly, fruit fly, it's called drosophila. And those are very interesting creature

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with genetic traits that we can study genetics, and metabolism that controlled by the gene. So I spent two, three summers with a professor. And we never, I

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never wrote a paper, but I enjoyed it tremendously. So I wanted to become a scientist. Okay. Now, so that-that school I was in, in high school, was-was a private school already.

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And so it's automatically like, I can go to college, if you-if you graduate with reasonable standing. So I was doing relatively well in the finals and everything.

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But uh, to study science, you have to go to graduate school. Now, that high school and college for Keio, at that time didn't have biology

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department. So I tried to take a entrance exam with national schools, with the University of Tokyo and Kyoto, and that kind of place. As you know, they're highly competitive right, you know, just like Korea, China, everywhere in Asian countries

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was extremely difficult to get in, as in Harvard, or Princeton, or, you know, Caltech and, you know, Stanford, those kind-I mean, in this country. So elite schools, the same thing.

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So I went to a prep school. And I said, "Forget it, I can't compete with those". So I was talking to my mother, and my mother said, "You know, if you want to do the biological scientific research.

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You know, your school has medical school, not biology, you know, independent graduate school. So if you go to medical school and become an MD, you can do essentially everything that biology PhD

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can do". So in the meantime, my sister was an excellent student. So she went into college and medical school. So I was inspired by that and so I studied

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hard. And so I went into medical school, that was my reason why, so-my motivation. Thank God, Japan, for the entrance of medical school, I didn't have to write an essay, you know,

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beautiful story to steer my career into medicine, you know, "I had a, um, something like, you know, very sick friends, best friends, and try to help him, I did a study and, you know, went into medical school".

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That's beautiful, but my motivation was to do biological research. So that was sort of very different, but once I went in, I enjoyed the biological aspect of it, and the science- scientific

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aspect of it. But in medical school, the primary goal is to make you a good doctor. And so I was exposed to the physician-patient relationship, how to

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approach what the humanitarian mission and so on so forth. And I really found myself really interested in that aspect of medicine. I think before I went into medical school, I was not mature enough to

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appreciate that. But during the medical school, I really developed that it is really an important and worthwhile thing to do. So that's why I went to medicine and still continuing it.

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Perfect. Um, so what- when did you study at the Keio University School of Medicine? So I actually I went into the Keio, um, not the university, but at Keio school that started with elementary school. And I went into by taking entrance exam

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in junior high school, you know, middle school. And so again, thanks to my grandfather, and he paid for it. And so I went all the way to medical

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school graduation in Keio. Perfect, okay. So you mentioned you were interested-interested in biology and you learned several other things. So were those the main subjects that you were interested in studying when you were in

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school? The funny thing is that, as I mentioned about drosophila fruit fly, I was really fascinated by genetics. And, to this day, I'm still doing the genetics. So it's important for you know, I think

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high school students, if you are genuinely interested and fascinating-fascinated by that subject, you can carry on, and you can have a lot of interesting things in your life. Yes, yes, for sure.

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So, during your studies, do you think there were any defining or pivotal moments that sort of helped shape you into the person that you are today, that you can think of when you were studying? Yes, absolutely. So that, uh, in medical school, I had a best friend, and he was an

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excellent student. And he had a photographic memory, he was really sickening, so smart. You know, I study hard, and hard and hard, and to get that, you know, good grade, or passing grades.

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This guy never studies. And he just remembers everything, he reads a lot. You know, he goes to library, instead of going to lecture. He often says, "Hey, you know, don't go to the lecture, they

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tell you outdated stuff. If you go to library, you can get current stuff, the hard stuff-it's much better". And, you know, of course, I couldn't afford not to go to

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my class, they take attendance. But this guy has a lot of friends. And he writes attendance, um, ballot, you know, to the teacher.

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Anyway, so this guy is really crazy that night before the final in medical school, everybody is supposed to be studying very hard. He calls me and said, "Hey, you know,

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tomorrow, it will be a very beautiful sunrise. Let's go to Izu, which is about, I would say 100, 100 kilometers, maybe 70 miles away from Tokyo. Let's go there and look at the sunrise and then come back

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and we can come back in time for testing". So I couldn't say no, so from then on, I really studied hard before the test date comes up. So then, like I pretend, just, "Well, you know, I don't-I

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don't need to study either". But that level of the brain intelligence is totally different from him and me. That seems like a very fascinating story. Yeah, so that guy decided he was really fascinated

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by American medicine. So in Japan, even then, there was lots of influence of German medicine, and then some neuroscience French medicine.

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Those are the top notch, and American medicine became really better and better, you know. And he said, "America is the next place to go to learn the best medicine".

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So he talked me into that. So that's the reason why I came to United States, I think, so he's a major influence, and uh, the biology professor,

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when I was a high school student and did the study of the fruit fly, and this guy, he's now a surgeon, but those two guys-two people really steered my life career. Wow, it's very insightful, do you know where they are now, what they're doing.

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what they're up to? Well, the professor died a number of years ago. But you know, I think I, my best friend is still in Tokyo and he didn't go into academics. He-he's studying medicine, and he's practicing medicine.

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And I also have to say my-my sister showed me the way to medical school in a way. And my mother, of course. Yeah.

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That's very, that's very sweet. Um, I guess talking about medical school and the differences, can you share what you think are the similarities and differences or weaknesses and strengths between medical students in the US versus Japan, and sort of what are the key

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characteristics you think make a good medical student? So the United States, quality of the medical students really great, and they study very hard,

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otherwise, you don't pass. In Japan, to get into medical school, like many other Asian schools. But once you get into, like my story of going to see the sun- sunrise, when you can, you can have actually

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that-that so before the testing, you have to study hard. But you know, you have a lot of time, free time as well. And the US system is much more organized, and much more comprehensive.

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There are not too many blanks and holes, in the education. And in Japan, it's hit and miss still- there are excellent areas in the select certain areas. And evidence-based or scientifically-based clinical practice

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much better in the United States. You know, in Japan, I-it used to drive me crazy. And the professor said, "Well, this drug is said to be very effective in this condition".

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Now, that's-in United States, it's not said to be, they say, "this drug IS effective, proven by this double blind, placebo controlled study" or something like that.

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So it's a difference. So that sort of uh, still guild system. The teacher tells students and students follow everything the teacher says, and monkey see monkey do.

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And sometimes without really critical evaluation of, you know, knowledge. So that was a very, very much different, it, that was actually 40

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some years ago. Now in Japan, of course, they-they learn, and a lot of improvement happened. And they're not-no longer doing that, but they're much less authoritarian. But they have to rely on the

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scientific evidence, so that the US and Japanese medicine became much closer. And in some aspect, some fields, Japanese medicine is leading. And so is in, you know, China or Korea, I mean, they really

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prosper in certain areas. And so I think it's an interesting experience. I think, in this global era, you know, that-that will continue to become more diversified,

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but at the same time, as a standard will become even. Yes, yes, very much so. So you mentioned that your friend inspired you to come to the United

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States after finishing medical school. Did some of your peers also want to come to the US? Were there any other factors in your choices? Yes. They're-about, I would say about

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5% of the class came to United States. And interestingly, all of them but me went back to Japan, because they may have stayed three, four years.

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But then eventually, they went back. Not in my class, but three, four years below me, there's one person, he was a close friend of mine. He is in California practicing in

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cardiology, and he is practicing, but at the same time, publishing papers, so very difficult. That's very interesting. So when you-when did you come from Japan to the US? You said in your CVs, 1974, Right?

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And then from medical school in Japan to your fellowship and residency here, did any of your family members come with you? Or was it just you? No, just me. So this was the first oversea trip

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for me. Surprisingly, I think that was exceptional, but I didn't come to United States for interview. I had a telephone interview. That's about it. There was no

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face, FaceTime or anything like that. They didn't know what I looked like in the motion picture. They, I sent a picture, regular photograph. So, but they accepted me and the hospital is called the

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Allegheny-Allegheny General Hospital in Pittsburgh. It's still there. And it was kind of scary that first night, I still remember, I arrived in Pittsburgh, I mean,

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Pittsburgh airport, and then my medical school's acquaintance's brother picked me up, but he was a banker. He dropped me at the hotel. And that was

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called William Penn hotel, it's a kind of old hotel, middle of downtown and I haven't eaten all day. So I became hungry. But a guy who picked me up from the airport said, "Don't go out.

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Downtown Pittsburgh is dangerous during the night". But I was so hungry and hotel restaurant was closed. I looked around and there was an Italian restaurant across the street.

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It's not too far, you know, just uh, I don't know, 40-50 yards. So I walked fast and open the door and then went in. So it was an Italian restaurant, not a luxury

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but you know, typical red and white checker shaped, I mean, patterned tablecloth, but so it's plastic, okay. And I sat down, and I ordered spaghetti meatball. Okay. And so I was eating-eating the dish.

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And then right next to my table, there was a guy who had long hair mixed with gray hair, and very poorly dressed. And he sort of stunk, a little bit.

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You know, didn't look like took bath for three, four days. So I was, I was eating and he started talking to me. So you know, my English was not that great.

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But I replied everything politely and, you know, smiled and asked, talked about family, where you grew up, you know, this kind of stuff. He apparently liked me.

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And this guy, poorly dressed guy bought me a beer, glass of beer. And I was so moved, you know? That was a great impression about the United States. Yeah. That's very, very hospitable.

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So talking-speaking of language, I suppose. Uh, what was the cultural transition like when you came here? And were there sort of challenges associated with that move? Oh, absolutely. I think everything's different.

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I forgot to mention, one thing is that is-I was in U.S. Naval Hospital in Japan. And in that hospital environment, at night and day, we speak English. And we

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prescribe American medicine, American names and the prescription format is different. So you get used to that kind of stuff. So I was quite accustomed to that,

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so that in the hospital during the work, there was no problem. But when I went to cafeteria outside of the hospital, in the hospital that I was an intern, and usually it's free, right?

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And, but outside during the holidays at night, you go to the cafeteria, then you don't know the rule, you know, where you pay and how you get the bill. And you know, how you pick

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up the tray, how you choose the food. And that was it, everything was challenging. So monkey see monkey do, sometimes you can make a mistake. And the bank-bank was terrifying because it's the

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money right? And, of course, there was no bank card or anything like that. You have to go to teller and write down all those slips and account numbers and everything. And so I didn't know that, you know,

00:34:41.500 - 00:34:56.070

this system is totally foreign to me. And so that was very, very scary. And then I had to buy a car. Okay, because Pittsburgh there are certain public transportation, but not really

00:34:56.070 - 00:35:10.480

great. So if you want to go out of town or something like that, just you want to have a car. So I bought, I bought a very cheap car, cheapest car. Still brand-new, I remember, I was very proud of it.

00:35:11.080 - 00:35:26.080

And-but I didn't know that engagement at the showroom. You know that, you know, the car salesmans, they are very slick, fast talk.

00:35:26.740 - 00:35:42.190

And that essentially they try to-try to get as much money out of me, right? Like, I had heard about that. So I was resisting, but I couldn't feel, where I give up

00:35:42.430 - 00:35:53.170

and where do I give in? And that was a very challenging thing. I still remember the guy was Italian. And whenever, you know, I negotiate or present him with a

00:35:53.170 - 00:36:11.970

number, he mumbles the numbers in Italian ca-calculating. And he goes back to the manager and come back. And but, you know, it was-it was very stressful. So everything is really challenging outside of the

00:36:12.010 - 00:36:27.170

hospital. So, indeed, in the hospital, I was more relaxed than outside. It's very interesting. Um, so you mentioned that you did have-know some English before coming there, so how proficient with English were you before you moved here?

00:36:27.480 - 00:36:38.280

And sort of, how did you get accustomed to the specialized medical terms? Yeah so, you can hear I have an accent, and I have awkward expression. I-still my English is not

00:36:38.280 - 00:36:53.000

100%, 100% proficient, okay, and my Japanese no longer 100% proficient either, so. What language I speak, I don't know. But- so it was a challenging, taking history from the

00:36:53.080 - 00:37:06.420

patient, how we start give instruction to the patient, those are relatively easy. But during the regular conversation, the greatest challenge was in the cafeteria in the hospital.

00:37:08.270 - 00:37:19.860

You know, you know those guys, but no, they're no longer speaking about medicine. They're talking about something else, you know, politics or car or whatever it is. I just couldn't get into that.

00:37:20.760 - 00:37:32.880

You know, that was so frustrating and intimidating. So it's more intimidated, you don't speak right, so it's-it's more difficult to join the conversation. That was a real challenging situation.

00:37:34.410 - 00:37:46.680

Fascinating. So beyond just having cultural conversational differences, obviously, you came to the U. S. way, way, way after WWII. But did you feel different from other people in any sort of way?

00:37:46.680 - 00:38:02.820

Did you feel like they didn't quite understand you because of that? Oh, yes. Um, you know, I think it's, it's sort of interesting that, you know, there's a stereotype of Japanese, you know, buck teeth, wearing glasses, you know. And, uh, "Ah so!", you know, that kind of

00:38:02.820 - 00:38:19.760

stuff that many people came up to say, "Ah so!". Yeah, that was sort of insulting, at the same time that's kind of funny. But Pittsburgh was really anti-Japanese, particularly. The reason is, uh, there was U.S.

00:38:20.170 - 00:38:37.190

steel and a lot of steel companies, and that those companies had lost a lot of jobs, and laid off a lot of people because stiff competition from Japanese steel company. So they didn't like that and they-they had

00:38:37.470 - 00:38:51.980

sort of Japanese bashing in the news and that kind of stuff. And atmosphere was pretty similar to some people in the United States go against Chinese at present time.

00:38:52.540 - 00:39:05.870

And, you know, similar sentiment was there. And, you know, plus the war, and Pearl Harbor. You know, I think we, I heard a lot of things and I

00:39:05.870 - 00:39:23.320

remember, during the Grand Rounds, which is a medical conference among professionals and residents, and when the December 7th comes, yeah, I think, of course, they speak about that and they

00:39:25.050 - 00:39:45.210

gave respect to the people who perished in Pearl Harbor, and minister gave little prayers. And so that made me feel this big during that time.

00:39:46.310 - 00:40:06.020

And so, there were certain uncomfortable atmosphere, and when you go to a department store and there are some Japanese product made, said made in Japan- hose are always looked cheap, looked

00:40:09.200 - 00:40:27.090

poorly made. Okay, so there is nothing much to be really proud of, you know, there are so many coming out-some Toyota started making cars, and but still quality-few years later, Sony became

00:40:28.080 - 00:40:42.070

fairly a household name, but at that time in the very beginning, it wasn't. Very interesting. So how did you sort of get used to the climate?

00:40:42.500 - 00:40:56.460

And how do you sort of fall into the process of learning cultural references, learning how to engage with people in a new way? Well, I think making friends and do things together, and you sometimes learn in a hard way,

00:40:57.110 - 00:41:12.600

sometimes I was laughing stock. Many times. That's-that's a great way to learn, you know, how things work in different culture. And yeah, but, you know, overall,

00:41:12.830 - 00:41:27.380

I was very impressed people are, in general, very kind. You know, every once in a while you, you feel bashing and you feel hate feeling. And, but

00:41:27.510 - 00:41:43.130

that, you know, I think people are people, and if you're good to them, people are good to you. That's a basic philosophy value I learned. Yes, very good value of peace, like you said earlier.

00:41:44.250 - 00:41:55.220

So you had this gap year when you were in Pennsylvania. So were there ever any other cities in the U.S. that you considered coming to? Or was Baylor College of Medicine a big deciding factor in coming to Houston?

00:41:55.700 - 00:42:10.010

That's kind of a funny thing, that, uh. I didn't think about Baylor. And so I wanted to get out of Allegheny General, it's not a bad school, bad hospital

00:42:10.010 - 00:42:31.030

for the training, but that I would like to go to better name place, you know, just like anybody else. And so I talked to many doctors say, in that

00:42:31.030 - 00:42:50.300

hospital, as well as the Naval Hospital, that you know, that trained me, and what place is good and they said, you know, certain names, and I wrote a letter to everywhere for the residency program.

00:42:51.410 - 00:43:06.010

And not many things came back. And actually breakthrough was twofold-through my connection with my alma mater, Keio's Professor, and he was a neurology

00:43:06.450 - 00:43:23.250

professor, and he collaborated very heavily with the chairman of the Department of Neurology at Baylor. So when I sent application, he wrote me back and said, "Yeah, if you're from Keio, and Professor such and such's

00:43:23.300 - 00:43:37.330

trainer-trainee, you're more than welcome". And so a few months later, I was matched to Baylor, so that's the reason why I went there. Interesting, so is that the reason that you chose to pursue you know, neuromuscular

00:43:37.330 - 00:43:49.560

medicine, neurology? No, I think neurology was, always, I was interested in nervous system. And now I research and

00:43:49.610 - 00:44:01.880

practice genetic disorders of nervous system. So I think that- that was, that was a great choice. And that's

00:44:01.880 - 00:44:17.080

what I wanted to do. And that, then I went into the neuromuscular disease because system is much, can I say, scientifically, a torture at that time.

00:44:18.160 - 00:44:36.970

Brain is a very complex black box. But for example, synapse-that's, neuron to neuron communication. A prototype of that is a neuromuscular junction, the nerve-peripheral nerve meets that muscle and the nerve orders

00:44:36.970 - 00:44:49.330

muscle to move. In order to do that, it uses a synaptic function, a release of acetylcholine, that's a neurotransmitter, for the presynaptic terminal to muscle, muscle has a receptor.

00:44:50.030 - 00:45:06.170

And then electric discharge happens and then contract. And so my first interest was that this is called myasthenia gravis, and that's the neuromuscular junction disease. There's our auto antibodies against that

00:45:07.220 - 00:45:24.990

postsynaptic muscle side receptors, and grab that transmission. So I view that as a prototype of the brain, synap-synaptic transmission. And later on, of course, I was interested in,

00:45:25.520 - 00:45:36.490

you know, the rest of the nervous system. But I got a very good introduction, and that made a lot of sense. I learned a lot from that. Wow, that's amazing.

00:45:37.370 - 00:45:49.640

So you're also pretty big, you had this international clinical research effort for understanding spinocerebral ataxia, right? It was a pretty big project, right? You mentioned that a lot of your collaborators were in the U.S.

00:45:49.640 - 00:45:59.630

and Europe with the European ataxia study group. Do you think collaborators with researchers from outside of that, like potentially, Asia would be a future form of involvement? Oh, we already interact with Asians.

00:46:00.750 - 00:46:16.500

And you know actually, I am, what do you call it, a guest professor of one Chinese medical school. And I went there at least four times and we still co-publish with a professor there.

00:46:17.050 - 00:46:32.300

And I've seen patients in the hospital called Chen Yen Hospital, I think I pronounced it right, but anyway. So ataxia network is expanding.

00:46:32.840 - 00:46:47.390

I know some people in India, some people, of course, in Taiwan, and Korea, and Japan, some of them, and even some people in Poland and Russia, I know-I know some people, investigators.

00:46:49.260 - 00:47:03.260

So now we are doing that initiative called Ata-Ataxia Global Initiative, AGI. I think that was instigated by a German professor.

00:47:04.070 - 00:47:19.850

And so we already collaborated with, within the study that you mentioned, already has an NIH-funded transatlantic study. So he invited me to this ataxia global initiative that includes South

00:47:19.850 - 00:47:35.480

America, that includes Australia, and so it becomes global because ataxia is-is a relatively rare condition. And so to get enough people,

00:47:35.960 - 00:47:53.330

enough investigators, and also, particularly in the clinical trials, we need a critical mass of this patient population. So that's very valuable initiative and international communication, friendship, trust, that

00:47:53.660 - 00:48:05.320

kind of things are very, very important. That's beautiful. So this, you've had a very storied career. So what are you most passionate about in your career? And what parts are the most fulfilling to you?

00:48:07.220 - 00:48:20.890

Well, I don't know. That's a very good question. But, uh, as I said, before,

00:48:22.400 - 00:48:39.700

money was not my goal. And well, actually fame is not my goal either. And it's sort of a self-satisfaction, in a way, it's, it's sort of

00:48:39.810 - 00:48:52.500

a not really a big ambition. But I would like to do good things, you know, and if I can contribute, that's great. And so if

00:48:54.240 - 00:49:09.110

money comes and fame comes as a result of that, that's okay. But those are not my primary goal, but the-I'm in the luxurious position, and I have a license, medical license and training.

00:49:10.270 - 00:49:25.330

And in medicine, if you're a practicing physician, you can't be that bad. So it's easy for me to say, you know, money and fame is not my primary goal and I will do the good thing.

00:49:26.020 - 00:49:40.080

But if you talk to a number of different people outside, who have different-different background from me, I mean, that's totally unfair statement. I understand that. So that part is I'm very happy that I

00:49:40.080 - 00:49:54.570

chose medicine, and I'm doing what I really want to do, and helping people, and at the same time having comfortable life and a certain respect. So that's really the highlight.

00:49:54.610 - 00:50:06.860

Thank you for that response. Um, you are practicing-you're a medical practitioner. And your office lists that you can speak both English and Japanese as-by you or the staff. So has this dual

00:50:06.860 - 00:50:18.230

language presentation been useful for potentially other Japanese American immigrants or those who are potentially more proficient in J-? Yeah, so most of the Japanese American immigrants, they speak better

00:50:18.230 - 00:50:33.450

English than I do . But sometimes, people from Japan sort of are sent from Japan, Japanese headquarter to Houston. I mean, they contact me, which is a special

00:50:36.560 - 00:50:52.300

situation, the disease, for example, ataxia or some other new genetic disorders. They contact me, and in rare cases, they actually flew from Japan to see me

00:50:52.300 - 00:51:05.820

and surprised me, because there are a lot of very famous Japanese professors in this field. And then, so they could have seen them or they may have already seen them, but I

00:51:05.820 - 00:51:20.710

felt very honored. Great. So um, do you have any-you wrote a lot about you know, your career in your form. Do you have any special hobbies or groups outside of work that you invest your free time into? What do you like to do in your free time?

00:51:22.490 - 00:51:38.390

Uh, free time? Let's see, I uh, when I was younger, I loved skiing, snow skiing. But in Houston,

00:51:38.390 - 00:51:56.830

there is no snow. So that was difficult, you know, when I was in Pittsburgh, it's every third night on call. But the second night after post-call, I always went to hour and a half away from city of Pittsburgh, there

00:51:56.830 - 00:52:10.090

was a small slope called Seven Springs. And somehow I still remember that big billboard said, "World Famous Seven Springs Ski Resort". I've never heard of it.

00:52:11.060 - 00:52:25.040

That was, that was my enjoyment. They have a nighttime skiing with a light. That's why after work, I could go there to ski. But, you know, I-as

00:52:26.820 - 00:52:43.140

recent as a couple of years ago, I went to Colorado, and other places in California, etc. But as you age, I start hearing about breaking bones, I remember the pope-John

00:52:44.920 - 00:52:58.180

Paul II was doing very well. And then one day, he broke his hip in skiing. And since then, he-his health and even mental capacity went south. So I

00:52:58.180 - 00:53:13.370

would be very careful. And nowadays, so I run, you know, probably three times a week, 5k until recently, I used to run 10k or 15k, but distances

00:53:15.090 - 00:53:28.870

getting shorter and time is getting slower. That means it takes longer, but I can't wake up early enough to run before my work. And so I

00:53:30.770 - 00:53:43.710

picked up another hobby that is golf. Golf is very difficult. And uh, it's essentially all here right? And that, it is

00:53:43.710 - 00:53:56.190

tough, but I enjoy it. But recently I went to this northern Houston golf course. And of course my ball

00:53:56.190 - 00:54:11.830

goes all over, right, hit it into tall grass. Next day I developed this rash. So I just went to a doctor for Lyme disease because those rash became very angry,

00:54:13.000 - 00:54:27.440

and almost like a bullseye rash which is known to be caused by Lyme bug, or malaria. So they run all the tests and that kind of stuff.

00:54:28.260 - 00:54:41.100

So golf is, I thought not dangerous sport, but not necessarily totally safe. Well, did you get your results back? Are you okay? Well, I'm okay.

00:54:41.130 - 00:54:53.710

I, you know, I started taking antibiotics and I shouold be okay. But yeah, it's an interesting experience. Wow. So what does your social circle consist of?

00:54:53.710 - 00:55:06.860

Is it mostly, you know, your family, you still keep in touch with people from Japan, maybe peers from Baylor? Yeah, all the above, right. Well, COVID was a challenging time, like everybody else.

00:55:09.080 - 00:55:21.400

You know, it's not easy for you to get out and have drinks, for example, or even dining difficult. Even within the family, just we used to go out to eat during the weekend.

00:55:22.650 - 00:55:36.720

But that's gone. Well, hopefully things will come back sometime soon. So how did you sort of bridge establishing yourself here with your family and your ties back home?

00:55:37.550 - 00:55:49.820

And how did you sort of choose to root yourself here? That's an interesting question. So I tried to go back to Japan, and there were a couple of times job

00:55:49.820 - 00:56:05.940

offer. So I interviewed there. But it didn't work out pretty well because I think U.S. work environment is pretty good. And particularly, the US work relationship is

00:56:06.160 - 00:56:19.480

very businesslike. In Asia, including Japan, that, I call it, you know it's not, doesn't translate well in English, but human relationship is wet, not dry,

00:56:19.750 - 00:56:30.660

so that's not businesslike. So if somebody's daughter is getting married, for example, you have never met the daughter or her future husband.

00:56:31.630 - 00:56:47.100

But if I were invited, I need to go, you know, I mean, in the United States, "Oh I'm sorry, I'm busy" I say, right? So yeah, I think there's an adjustment and I like the U.S. social rules

00:56:49.260 - 00:57:03.010

in regular circumstances much better. But when there's something really challenging happens, that Asian society has very valuable quality of human relationship.

00:57:03.740 - 00:57:20.620

Very strong tie. And that's-sometimes in the United States, except for the very close friends, you know, among strangers not very tight. But having said that, we have two seconds, two minutes.

00:57:21.350 - 00:57:38.630

So my car was broken about three years ago, and just past a railroad crossing. So it stalled there, slapped on the trunk and hood, and it was

00:57:38.630 - 00:57:54.550

getting dark. And my cell phone's battery went down and I couldn't call anybody. And a car passing by and, you know, offered me to call somebody and I-they

00:57:56.180 - 00:58:11.810

called my wife and as she was coming, but it was really getting dark. So I worried about it. Then this, on the railroad track, there was an engineer

00:58:12.830 - 00:58:28.450

just stopped that locomotive. He got down, he-he was watching me. And he took this lantern, you know, railroad lantern, and walked to me and said, "Here, you need some light.

00:58:29.710 - 00:58:39.420

And you can-you can have it, this is-this is old, but it still works". I mean, just isn't it nice? You know, otherwise, it's gonna be pitch

00:58:39.420 - 00:58:52.410

dark, you know, all by yourself. So, yeah, good things happening. Yes, very much so. I guess I still do have a few more questions if you have the time.

00:58:52.410 - 00:59:05.650

Sure, yeah, I do. Um, so you mentioned you know, sort of the business cultural differences and other differences in that lifestyle. So as a first-generation immigrant, have a lot of the cultural values and differences

00:59:05.770 - 00:59:22.130

been an important part when you raised your children, and what do you specifically believe that you have given to your kids or have translated to them or they have taken up? Ah, that's a good question. And you know, first kid and last kid, totally different

00:59:22.770 - 00:59:38.540

in relationship. The first kid, you're excited about of course, and last kid, I was excited about too, but the expectation-you have an unreal expectation in the first kid and it's totally unfair.

00:59:39.590 - 00:59:55.190

And so relationship was, in a way, I wouldn't call it tense, but it-it's a very father-son relationship, typical Asian type.

00:59:56.870 - 01:00:11.450

Okay, so the last one is, she's-I married twice, and so second marriage. And she's still very young, a teenager. So this one is just like I was acting like a grandfather.

01:00:12.820 - 01:00:31.960

And she's a very independent thinker. And she doesn't bother me, at the same time, she oftentimes ignores me, ignores me, and that's okay with me and,

01:00:32.320 - 01:00:48.770

and I love her to death. And it's really nice to watch her with a little bit of space between and watching her growing up. And as a mature person, that's very

01:00:48.770 - 01:01:05.160

delightful. It's a different, different type of child rising, raising. And so I have four kids, and four grandchildren. And three of them are the United States,

01:01:06.160 - 01:01:15.810

and one is in Japan. He was born in the states, but he decided to live in Japan. So that is kind of cool, and he complains that he is,

01:01:18.630 - 01:01:35.950

obviously that he's half Caucasian, so that he stands out in Japan, his complexion is rather too light for the Japanese society. And he gets really mad because he is walking on the street, and police stops him and said, "Where's your passport?" He said,

01:01:36.830 - 01:01:49.780

"I'm a Japanese citizen". Let's believe him, you know, it's really frustrating. And he feels it's much easier to be mingled in the United States than in Tokyo.

01:01:50.390 - 01:02:05.590

But he at the same time, loves Tokyo, loves Japan, Japanese culture and foods and you know, those things. So, and also people, I mean, my other kids in the states love to visit

01:02:05.670 - 01:02:22.480

there and, you know, visit Asia. And that's a luxury, you know, certainly a great thing to have. Wow, yes. Um, so speaking of sort of different generations identifying, do you personally identify as Japanese, Japanese American, American?

01:02:22.710 - 01:02:32.300

And how do your kids identify as well? So I'm not-I'm not naturalized. I'm a Japanese citizen. That's my, I don't know,

01:02:33.710 - 01:02:49.860

I-so in Japan, if you take-if you're naturalized in another country, you are supposed to automatically lose your Japanese citizenship. And, and

01:02:51.370 - 01:03:12.440

I couldn't do that to my parents while my parents were still alive. But my mother died about four years ago so I have no obligations to keep that. But somehow, after all those years, you know most likely when I go back to Japan, some people say, "Wow, you haven't

01:03:12.440 - 01:03:23.970

changed". But some other time, they say, the same person said, "Oh, you're so Americanized". And people in the United States tell me the same thing.

01:03:24.700 - 01:03:38.820

You know, "Wow, you know, you, you really are accustomed to U.S. culture". But at the same time it's, what do they say?

01:03:39.810 - 01:03:57.470

One of the persons said, "You can take a boy out of a country but you can never take the country out of the boy" right? So it's a very complex feeling inside. But I kept my identity as-as a Japanese citizen,

01:03:58.350 - 01:04:13.330

but I told my kids it's totally free to choose whichever, what to be. If you don't declare, you know, even on paper, it says U.S. citizen. They don't revoke.

01:04:13.670 - 01:04:27.820

The only problem is that to get to U.S. citizen, you need to have a current passport and so that's little bit of a complication. But many Japanese still do dual citizenship after they grew up-grow up.

01:04:28.380 - 01:04:43.130

I don't know exactly how they did it, but. So it's my conscious effort to be Japanese, but at the same time, you may have sensed already that I don't-I

01:04:45.210 - 01:04:57.540

try to be a human being, you know, before a Japanese American or someone, you know, what, what have you and those things are not really important to me. I'm proud of

01:04:57.540 - 01:05:14.560

my heritage and you know, I like the culture I grew up in. But that is not really the point, you know. Yes, very much so. Um, as you mentioned, sort of earlier in the interview about the sort of rising

01:05:14.560 - 01:05:26.500

anti-Asian sentiment in the pandemic, obviously, you know, people don't really, don't know the difference, right? But how do you feel as part of the Asian American community here? Or at least someone living here?

01:05:26.500 - 01:05:39.160

Have you felt that those sentiments are an important part of how you identify as part of this, or have you sort of engaged in any of that? Okay, so that-that was a real cultural shock, I think I didn't mention, but Japan is a very

01:05:40.050 - 01:05:52.280

homogeneous society, right? And nowadays, there are a lot of foreign people living in Japan. And you know, I really didn't have any concept of so-called

01:05:55.300 - 01:06:10.880

prejudice or hate, or racial discrimination or anything like that. And, you know, some people say that Asians have things against Africans, you know, because

01:06:10.910 - 01:06:26.420

of skin color change. But in Japan, all those African people are very, very successful, and very well read. So, growing up in Japan, and talking to those people, I had a

01:06:26.600 - 01:06:43.550

different bias that the average, African American more well read, the reverse of other people. But then I found out so-you know, this, I knew that intellectually, I read newspaper and everything.

01:06:44.770 - 01:07:01.790

So poverty issues and other things that you really feel with your skin, then you understand there is a real threat of discrimination against race. And so

01:07:01.990 - 01:07:19.540

when I came to the United States, I didn't feel like I was a minority because that time I was out of Japan. But over the years, yes, you feel and also just listen to, not only read, but listen to people who fought

01:07:19.540 - 01:07:35.820

against discrimination in California, for example. And-and it's really eye opening, and I think we, I'm not really try to promote-what

01:07:38.370 - 01:07:57.710

can I say? It's anti-racism, but it's not, I don't like certain people in the social sector, who exercise in that kind of discrimination feeling.

01:07:58.170 - 01:08:11.680

I mean then, I look to an animal field, I mean world, mean, if you look different, you know, they try to outcast and circumstance, the normal psychology, but I think we can intellectually overcome those

01:08:11.850 - 01:08:25.960

differences. And after all, I feel you know, it's a human being is a human being, and we can develop a good relationship, and very pleasant world you can make. Yes, for sure, for sure.

01:08:26.440 - 01:08:37.890

Um, so oftentimes, you know, medicine, for example, is assumed to be somewhat of a universal constant, you know, saving and improving lives is the mission no matter where you practice. Do you find that to be true?

01:08:38.150 - 01:08:52.250

And do you find that oftentimes, many Asian Americans in the medical field are very respected? So do you think that sort of has an impact on bridging cultures? Yes, medicine is very important, but at the same time, I feel very guilty.

01:08:55.860 - 01:09:15.860

My teenage daughter, she adores Doctors Without Borders, okay. Now if I-somebody asked me and do I abandon everything and go to war-infested zone and, you

01:09:16.280 - 01:09:34.400

know, join them? I didn't and I, I'm not going to do. I feel guilty about that. And I respect, admire those courageous people. And, you know, medicine should be like that, and

01:09:34.590 - 01:09:49.190

it's easy to say ideal. So I think I feel there are certain limitations that everybody carry. And, but it is also important, not everybody can be, you know, Doctors Without

01:09:49.310 - 01:10:07.070

Borders. And you have to do what you can do, where you are and now. So I think that is an important thing. Yes, you have a very special expertise area, which, um, very much so, very

01:10:07.070 - 01:10:15.690

respectful-and you are helping people where they are, which I find very respectable. So speaking more about sort of this memory of identity, I suppose.

01:10:16.030 - 01:10:28.310

Do you have any specific hopes for future generations of your family? Especially since you have, you know, children in Tokyo as well as the states? Do you have any specific cultural aspirations or aspirations for them? I guess— So, absolutely.

01:10:28.310 - 01:10:47.150

I think it is interesting. My current wife is Chinese, from mainland, and my next door in the office, in my next office, is a faculty, she was a Korean from, Korean American from

01:10:47.210 - 01:11:02.580

California. And, you know, I have friends from India, a lot of collaborators, and one person from Bangladesh just asked me to write a recommendation letter for the promotion to associate professor.

01:11:03.180 - 01:11:16.690

And, you know, there's number of different people from Asian countries. And, but at the same time, people from Europe do the same things as America, they do the same thing. And but, you know, I feel

01:11:16.910 - 01:11:31.330

close to other Asian people. And you know it's, we have certain disadvantages and advantages, for example, not many Asian people are tall.

01:11:31.860 - 01:11:47.580

Some Indians are tall, but you know, just East Asians particularly. And so, according to some statistics I read, the height is important for social success.

01:11:48.370 - 01:12:06.210

Okay, that's clearly maybe true in American society. So I, it makes me smile, when Asian people with short stature is doing very well, it makes me smile, for example.

01:12:07.400 - 01:12:23.680

And so I love to go to Asian festivals. And, you know, it keeps me-after all, we have thousands of years of cultural exchange, and regional

01:12:23.780 - 01:12:39.560

area in East Asia and that's, that's very precious. And I think we have commonality among us. So even Indian people have Sanskrit, and through the Buddhism, and we

01:12:40.060 - 01:12:55.640

understand certain concepts. And that was interesting to carry on the conversation to compare. And, you know, that kind of experiences, and Koreans and Chinese and lots of that was a common, you know just I found

01:12:55.640 - 01:13:07.690

out, what are they called, "dian hua?" Dian hua, telephone. And it's a sort of a universal Eastern Asian language. And linguistically, it's very interesting.

01:13:08.230 - 01:13:21.060

But at the same time from genetically speaking, diversity differences in different regions of Asia. That's also fascinating.

01:13:21.800 - 01:13:37.980

And yeah, so I, I enjoy and I feel, I feel, all Asians are in the same families that I belong to. And you know, we

01:13:40.190 - 01:13:54.280

collaborate through friendship, you know. I think that's a great thing to do. Yes, very much. And just a few more minutes of your time, I guess you mentioned that you sort of have this difference in identity between feeling, wanting to still be

01:13:54.280 - 01:14:07.260

naturalized as a Japanese citizen versus being in America. Could you elaborate sort of on your memories or your conceptions of that dual identity? Yeah, it's more like, in my case, I think many

01:14:07.290 - 01:14:23.250

immigrants case, to some extent, it's physiological, okay? When I was young, I could eat everything, you know, I can go anywhere. I was not afraid of anything. As you get older, food preference, could

01:14:24.810 - 01:14:38.380

regress, and more and more I prefer white rice over bread, okay, I still like bread, you know, I buy French bread, you know and that kind of stuff. I like

01:14:38.400 - 01:14:51.930

pasta. But particularly when you get sick, you wanna eat white rice or something like that. And so I go to grocery store, Japanese grocery store, Asian grocery store, at least once a month, something like that.

01:14:52.560 - 01:15:10.020

And so that's sort of a physiological memory, you know, the body, and the culture is to some extent that nostalgia, comfort there. That's, uh, that's an important aspect-also, if you calculate your molecular

01:15:10.110 - 01:15:22.790

turnover of your body, most likely I'm 90-99% American molecule made, you know? That's very fascinating. Yes, I have heard the statistic.

01:15:23.640 - 01:15:30.790

Anyway, but thank you so much for taking the time out of your day to answer these questions. I found them very fascinating. And, again, thank you

01:15:30.790 - 01:15:42.790

so much for answers and we will follow up with an email and the transcript, so. Okay, I hope it's helpful. And I'm looking forward to your article. Thank you so much for your time.

01:15:42.790 - 01:15:45.930

This has been great. Okay. Thank you. Bye bye. Thank you.