CSR

Today I joined the lecture by Living in Peace which is NPO support Burma etc. They try to do educational support in child care center in Tsukuba.
First some professor did lecture on " poverty in Japan" but I didn't realize the poverty situation in Japan yet. I think at most 1% of people are poor in Japan; they cannot afford their money enough. But he told 13% of people are poor... I have evidence of my saying. anyway
After that they talked about the severe situation in child care center. Children there don't have any hope .... It is unfair of chance (job opportunity)! I hate " unfair "
I support them by paying a bit of money.

HARD BUT EXCITING DAYS

On Monday I was day-night float and did paper work. Next day I had an operation of Mitral valve case. It was plasty case and did foldplasty(?). P3 chordaes are elongated, so make a reduction suture on the mitral annulus and did kind of purse suture to fold the excessive mitral valve into the LV side. It was so effective and simple. but don't know why it is effective...

After that we had a VSP case. Inferior wall rupture.

I didn't participate in the operation but I enjoyed observing that case.

I couldn't sleep

Today I had CABG took SVG that was fine. Today's case was so hard...

I have never seen this kind of thing. Anyway enjoyed

Today

Now I am on night float. In the morning I did some jobs on the ward and saw all the patients who stay in the ICU. Took off the drain in the pericardium and mediastinum. In the afternoon I took a nap for half an hour, and did paper work ! TOOO Much !

Now finally I have finished the paperwork and today has finished ! I am practicing the procedure required in the operation. Tomorrow I have MVP case as an assistant.

last week

On Monday

I couldn’t sleep last night. So sleepy! Today I didn’t have any operation, I did ward work (took some nap ! )I saw the all patients responsible for me. That was the first job in hospital after vacation. After that I went to part time job(night shift). I woke up 6o’clock , being still sleepy, went to the hospital and had AAA surgery, It was so hard to do because of adhesion. I wonder what makes that adhesion. She only had a history of myomectomy of uterine. It seemed that it localized around the colon, I was sure that she has some inflammation of the colon before surgery. On? My plan of this operation, I was going to do Y graft ,but indeed straight graft. Bleeding is not so much; she seems to be fine right now. After this operation I did ward work and did night shift. On 2 o’clock I had a call that the lady has bradycardia. I checked electrolytes and echo, but no remarkable change. So I decide to keep conservation. Another patient also had bradycardia. As for him it is not unusual because he has sepsis and had biggest operation. So I decided to continue observation. After that I had an emergent call . The patient who had a AAA opration on Monday had abdominal pain and bleeding I checked APTT but nothing was particular.After that I had emergency who was discharged on Monday. He complained of dizziness I checked Blood Pressure and it was 60 on systolic ! So low ! I gave him volume and after that BP got over 80. After that conference was held for the operation plan of the next week. I made a presentation of CABG patient and TAA patient. But the patient in charge was totally different LOL!! After conference I had emergency and also did shunt operation、and also did the outpatient clinic and patient care on the ward at the same time ! It was amazing that I couldn’t deal with it. It was difficult to do that. Too hard. On Thursday I did PTA and out patient clinic and also did CABG as assistant. I went home midnight. ON Friday I went to part time job of the outpatient clinic it was relaxing time for me. No need to care the ward.

We had two observer who will apply this hospital. I didn’t do anything but drinking with them . Yesterday I went to transplant congress And went to funeral event of my coworker’s father. After that I went to have a drink with my friend of GAS member.

This week was too hard for me to deal with it !

Wedding party

Now I am in Taipei to participate in the wedding party tonight ! The bride of this ceremony is my friend. She is powerful woman and funny. The groom is the best person I have ever seen before He is a really nice guy and smart. I like him so much although I have seen him only twice.

The weedding party must be great. The groom is a rich man. He is nece , good-looking and smart. which means perfect!

The bride must be happy! I hope they lead good lives!

departure

Now I am at the JFK airport and waiting for departure. This visit was very meaningful for me.

First I could meet my friends ! A friend of mine who works in BIMC as a intern, seems to be fine. He complains about the different systems between Japan and the U.S. ; means the latter is more unreasonable which is surprising for me. Now he is PGY5 but works as PGY 1 which is very meaning less as a medical career but good for improving his English skills. He looks works hard and I know his potential is incredible! He must survive ! He is a best resident I have seen before .

And I also got importatant information here. My ex-senior colleague told me Keio residency system is now changing for good course because it lose popularity and many residents quit their position because of poor education system. I was so surprised the fact because I believe it never happens.

I met another friend who is so cute girl. How I met her is secret because I broke my rule. But she is amazing ! She come here NY by herself and works at aparrel world. She is very good girl although she looks inocent.

I passed the interview that was another big surprise for me !

Anyway everything is in good course and I enjoyed a lot.

interview with my new boss

Yesterday I had an interview with my new boss. He is thin white guy (looks like Italian guy). He has twin in the same lab. I talked with him for a short time and know each other. talked about my plan for the future.
His assessment of my English is 'good' ;means ' not so bad ' or ' can make a communication. It was surprising that I was assessed like that,because I don't have any confidence on my English. I have decided to brush my English skills up , first vocabulary.
The interview finished in an hour, so I had a bunch of free time,which is rare in this trip.

First day (Monday) I observed operations done by Dr.Bavaria who is a sub chief of this division. He is one of the busiest man in the world. He works so hard. It must overcome Japanese style. He wakes up and come to this hospital early in the morning and do four cardiac operations including new technology one. He cares about me much. I don't know why , but he is a kind man for me.

Anyway I am enjoying this stay in Philly.

MT

nothing to do

on Saturday I had finished my work until 13 o'clock and had some lunch. I went to Chinese restaurant which is famous for its Mara-mem. I didn'T notice the existence of Hanasansho which is spice for "Ma" . Anyway taste was not so ad. After that I picked up my motorcycle which was broken for accident last year. the brake wire and accelerator wire was broken. It costs about 3o,ooo yen . Not so bad .

.Today I will meet Dr. Akihiro ,who works in Columbia University. I want to work in the U.S. for some reasons.So he is a model case for me. I'm not sure what he thinks , but he is also yui's friend. So he is so important for me.

Next week I will meet Dr.Lefor and after that I will go to the D-lab seminar.i am really interested in the D-lab because it is what i want to do.

I try my best to get into the D lab ....

I am wondering if I should go to the U.S. ASAP or not....

3/15

I went to Kaplan to make a debate. There, we were talking about the pension system. And I opposed to the current pension system. My proposition is to substitute the tax to the national pension. the reason why I chose national pension is National pension is not depend on the income.

So it'S so easy to application the advantage of this is " fair" and " easy".

First "simple". Current pension system is too complicated that those who had loss can't realize so. Indirectly they are deceived...If this happens the system gets easy to understand that they can criticize the pension system ,and it will get the motivation to take part in the election.

Second," fair" . Now the burden to sustain the elderly citizen is told like this ; 3people sustain an elderly. But ,because of low birth rate and aged society, it is increasing ; it is said to reach 1person to 1 person.,which is too heavy. But if the tax system is applied, it will reduce by //// . And also there are too many tax evaders in national pension. It is because of not good publcity, luck of PR. and there are also people who cannot afford for that.But in the future they can't get pension ,but there will be some support system for that ,which means they don't pay but they will get some profit. It's unfair.This system apply the consuming tax which means people who buy more pays more. There can't be no tax evader. And we can collect money from elderly citizens.

I think this system is so good that this should be applied neat in the future.

2/12@ ICS

I participated in the open forum of Aoyama Univ. Ishikura seminer. the discussion theme was Ho to make a global leader in 21st century?

I realized that I am so worried about my poorness of the way of construction of debate. I found difficulty in debate. So we couldn't reach the answer. Someone told me some question had no answer , but I believe we need the answer and we have to make our answer by ourselves.

The debate was not well-prepared actually. I think we should prepare for our own answers.

But still I realized my answer. Studying abroad and language and also enter the global pathway is the must.

Before next GAS I have to make a story of my theme. Anyway I try to keep myself enjoy in any ways.

Sunday

When I woke up this morning, it was already around 8 o'clock. As it is very cold recently, it gets difficult to go out of bed. I felt sleepy, but I know it is waste of time, I went to my hospital and went the round. I decided to have a running today I ran from my house to Akasaka and came back again. It took only 50 min but it was tough because recently I have ditched running recently. I felt guilty for that, so it was releasing and refreshing for me. When I went home, it was already around 10:50.

I went to lunch,today was Chi-ran , whose tan-tan-men was marvelous.

After lunch I went to Shibuya. Shibuya has big parking area for bike. It was helpful for me. And I bought boots and shoes. My sneaker was so dirty that I can't go to good restaurants with this shoes. They totally cost about 300$ but reasonable.

After that I rode to Roppongi and study marketing. Today I did finish only 1.5 chapters. It was disappointing. But anyway I got forward.

Now I'm in night shift.

Also I want to read the marketing book and Cardiac Surgery .
I HAVE TO WORK HARD

TRY HARD !!!

Today's achievement

Marketing by Cotler 8and9 chapter

finish the pension report

made referral form

homework cardiac surgery and marketing book and issue analysis

Saturday

Yesterday morning I woke up late, around 9 o'clock. As soon as I woke up ,I went to hospital and went the round. I did surgery yesterday ,and the patient was fine. urine output was enough and she felt nauseous , so I administered metoclopramide to suppress the symptom. It was successful. It helped her so much. Otherwise every patients are in good condition.

After the round, I went to lunch with my intern. He is patient enough. He did anything I told him. But he has only some problems. First he isn't interested in surgery. Another thing is that he doesn't do anything on his own initiative. I'm wondering that I should tell him that. It is partly my fault. I do everything by myself. It's big problem for him.

Anyway I had lunch with him at Ryukotei. I like Chinese of Ryukotei. I had beef lunch.

After lunch I went to Ropongi hills to study marketing. First I read the problem solving paper written by Dr. Yoko Ishikura. It was a little difficult to understand. Because there are some technical terms like 5 powers of competition.

I understand MECE because I use this all the daily life. But as for Issue analysis, I couldn't even understand the contents. It said it is useful skill. So I try to obtain this technique.

When I left roppongi , it was around 23 o'clock . I read comics and watched TV as always and went to bed.

The future

Yesterday we discuss about the future of the world . Masaru told that there will be international recruit. We will have to go abroad to get good jobs. The power of BRICS is getting stronger, as the industries there grow rapidly. Annual growth of GDP of China was about 8% ,which is double of Japan. In the next year China will overcome Japanese economy. This　doesn't mean exactly what it is, but that the world gets flat.

To adjust this change, we have to learn more other countries' languages , of course including English.

I made a presentation about the future of medicine. I proposed main theme ' we will overcome the all the diseases' and 3 reason for that. I called it ' DIG' project

At first we have gene therapy. Columbia group take it in practice two years ago. They inject some virus including treatment gene. By doing so we can change the gene. I am afraid I gave them misunderstanding but not far in the future it will get major.

Second we have iPS. The teacher asked me the meaning of iPS(induced pluripotent stem cell)

I couldn't answer it. iPS can get anything in your body(pluripotent) we can make it from skin.

third drug evolution . clinical trial get easy because of the communicaiton tools.As years go by,there are many evolutions.Twenty years ago we can't even imagine we can treat the

vaccination of flu

The vaccine of flu has been approved finally.

I was so surprised at this fact because other countries deal with this problem more early than Japan. And also the peak of flu has gone.

Why did this happen?

The Japanese government has to change their attitude, it is too difficult to use new medication in Japan although there are so many clinical experiences and the examination was done. This cause drug lag and the we Japanese can't enjoy benefit of medicine for it.

We have to 'treat' this problem ASAP...

have a drink with my friiend

I had a drink with my friend last night . I've been along with him for 8years since I went to prep school. He is smart and active, that is why I like him.

He took me あそこ in Azabujuban ,which I didn't know, very good bar. His girlfriend also came, and we talk about many things, such as parents, work , and dream.

As for parents, he experienced interesting event. He sent his mother Louis Vuitton Bag which costs 1000 $ and send his message . His mother cry for his kindness. I was moved a lot, such a great experience. He is a very kind guy.

My mother is very different from other mothers. She is very active , always hysteric, but very kind to me. I realize I didn't do anything for my mother. In my childhood I gave my mother a present like massage ticket or something, but never bought anything for my mother except for flower.I regret not to give her any presents and decided to send her something on next her birthday ...

His girlfriend works the same office as his. She grew up in Ohio state. So she is very good English speaker. She is so cute like Ayako Nishikawa and very kind girl.

I had a very enjoyable time.