This is my first time to visit Japan. Strangely so, I feel a sense of recognition during the visit of one of the shrines in Tokyo. As if I have been here before. The philosopher Friedrich Nietzsche wrote religions are often successful due to their opportunity to be the first to indoctrinate the blank sheets of children’s brains. Suddenly I get it. The Torii gates, the little buildings and even the decorations at the roof were the scenery of the endless levels of Pokémon, Super Mario and Kirby. As a child, I spend long road trips to France and rainy Sunday afternoons in Japan. Nintendo was my religion, the Gameboy my bible.
Two days later, I am standing in the operating room of surgeon Umezawa. “Mesu.”, she asks, holding up her gloved hand to the theater nurse. Just as I had gotten used to the endless stream of unknown words and characters, this word sounds very familiar. It does indeed mean ‘knife’ (mes in Dutch). Though, it shouldn’t have been a surprise to me. About 250 years prior to the introduction first Nintendo game computer in The Netherlands, the VOC (Dutch Easti-India Company, a shipping multinational founded in the 16th century) obtained a bonus level at the coasts of Nippon. During a 200 year-period (1633–1853) of so called sakoku or isolationist foreign policy of Japan, the Dutch received an exclusive trading post in Dejima, a small island in the bay of Nagasaki.
But it wasn’t only trading that took place. During this period, Dejima was the only window towards the West regarding science and was of great importance in medicine. As performance of post mortem dissections was still illegal in Japan, the works of Vesalius with detailed sketches of anatomical structures of the human body circulated all over Europe. The surgery of the Dutch was known as Komo-ryu geka (surgery of the red haired) and soon came to be known as a service of good quality. Japan is a country where the art of cutting seems to be deeply engrained in its culture. Therefore, it was striking that these blunt Dutch with their sharp knifes set the surgical standard.
Conversely, the knife remains merely an object of detail in the operating room. While I hold the camera, dr Umezawa carefully dissects the plane between the gallbladder and the liver. Her precision and attention to detail are impressive. She is one of the most renowned surgeon in Japan regarding laparoscopic cholecystectomies, the removal of the gallbladder through a minimal invasive procedure.
The concept of a laparoscopic operation has a striking amount of similarities with a computer game. Through several tiny incisions of only millimeters, a camera and two or three operating instruments are introduced in the abdomen. They are a type of long sticks with little scissors, a grasper or a coagulator at the tip. You can see what you do on the monitor.
The next morning, we bow for the patient, doing fine by the way she is happily slurping her miso-soup for breakfast. The modern surgeon and the modern patient tend to prefer minimal invasive surgery. The precision and the techniques of the East and the anatomical knowledge of the West have joint in to a hybrid form of modern surgery. The result gets near to what Hippocrates one day stated in his oath: Primum non nocere (First, do no harm). So next time when you see your 8-year old being infatuated by a digital world, don’t forget: he might be learning new languages, new countries and new skills.
梅澤博士ありがとう!
