That time of year again…

Yesterday I submitted my report for the third quarter of the Watson: 9 months in, 3 to go. This is what I wrote (warning – it’s long!).

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Tokyo’s Midtown area.

I’m writing this from a park in Kichijoji, a small trendy neighborhood on the outskirts of Tokyo, and it’s the calmest I’ve felt in a while. The cherry blossoms here have been in full bloom all week, and now their short period is ending – the trees are turning from pink into green, scattering their petals all over the ground. When I submitted my last quarterly report in January, I was still in India. Since then, I’ve participated in a health camp in rural India, closed the chapter on my long and demanding visit there, spent a quick two weeks in Singapore, and traveled to Japan. I’ve been in Japan now for nearly 8 weeks now, and I have another month to go.

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Sakura petals have been blanketing everything lately.

One of my last weeks in India, I traveled with a company I had interviewed in Bangalore to the tier-two city of Bhopal up north. For five days, we joined a group of volunteer doctors who had traveled there to do “health camps,” one-day pop-up clinics in rural villages around the city. Each morning we got up early to pack a bus with basic medical equipment and travel the 1-2 hours to a predetermined rural village, where we registered villagers and gave them basic care based on their complaints. I was one of the few non-Indian and non-Hindi-speaking attendees, and along with my complete lack of medical training, it all made the event a hugely humbling one. My job was to administer blood tests using a small device, and it was my only time on the Watson actually operating a medical device rather than interviewing someone about one. I saw firsthand the fear that comes with a lack of awareness – adults scrunching up their faces in anxiety and pain in response to a little finger prick, the same way kids do with pediatricians. As many interviewees had told me, lack of awareness is one of the biggest barriers to acceptance of medical technology in India.

By the time I left India, I was exhausted. I had done everything I wanted to do, and I was ready to leave – or so I thought. It’s still hard to say goodbye, and I struggled with that my last day there, especially leaving Mumbai. I had left and returned to Mumbai so many times by that point that it was starting to feel like some kind of home. The further along the Watson gets, the more people I meet and the more friends I say goodbye to. I thought my presence in these places would be too transient to make real friends, and I’m thrilled that hasn’t been the case, but it certainly doesn’t make it easier.

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Art at Nittele Tower, Tokyo.

Then I arrived in Singapore, a late addition to my project. I decided to go while I was in Qatar because I learned there that Singapore was ranked by The Lancet as the second-healthiest country in the world, and by the WEF as the world’s most “technology-ready nation,” and I wanted to know why. I allocated only two weeks there because Singapore is small and because I wanted to stick closely to my original Watson itinerary.

I was amazed by the nation-state when I arrived and a bit disillusioned with it when I left. First of all, I realized that two weeks is not long enough to spend in a country for my project (the four weeks I spent in Qatar were a good minimum). It takes time to grow these “connection webs” – the networks that form when you embark on interviews, when you finally meet the right person who connects you to an opportunity somewhere else, or links you to another person to interview, and so on. The opportunity to do the health camp in Bhopal, for example, was several months in the making. It was frustrating in Singapore to learn that two weeks simply isn’t enough. At the same time, Singapore is tiny, and I was fairly ready to leave after two weeks. I didn’t get a great sense of attitudes towards medical technology there, but I did learn some things through my few interviews. It seems that Singapore’s high health ranking is mostly due to the tight control of the government over its small population and the fact that Singapore’s nationals form an even smaller, high-income group that can afford good healthcare. I actually started to notice a lot of parallels between Singapore and Qatar, as both countries have many expats and migrant workers, as well as highly involved governments. Though Singapore is certainly “technology-ready” and a tech-enhanced city, most medtech companies there are using the city as a Southeast Asian hub, with large manufacturing facilities taking advantage of the low taxes. There are very few start-ups or products tailored specifically to Singaporeans.

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Not what I expected to find in Tokyo! An American apple pie restaurant appropriately named “Granny Smith.”

By the time I came to Japan, I was excited to do something different. My time here has been characterized by homestays, far more so than in any other country. Nine of my twelve weeks in Japan are spent living in Tokyo with two Japanese host families that I found via a Swarthmore alum. My nightly fee includes both breakfast and dinner, and this complete immersion into family life (especially with families that speak minimal English) has been new and wonderful. I spend less time writing on the blog or setting up project meetings, but it certainly seems worth it for the way I’ve gotten swept up in day-to-day life here.

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I went on a nighttime boat tour of Sumida River with my host family. This is the Tokyo Skytree building disappearing into the fog!

I’ve loved jumping into life here as though I’ve always been in Tokyo. I took a full-time Japanese class for two weeks, which was a great way to have structure outside of the project and feel like a Tokyoite commuting in the city. Those two weeks constitute my only language study on the Watson, so I’m happy that I was able to do that here. The week after my class ended, two of my best friends from home came to visit me in Japan and we had an amazing time traveling together – in addition to the week around Christmas when my parents were in India, that’s the end of visits for me. Immediately after they left, I traveled with my second host family to Okinawa.

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A beautiful green walkway that stretches for many blocks – very close to where my homestay is.

With all this going on, and group travel unlike what I’m used to on the Watson, I’ve had fewer project meetings than in other countries so far. But since Japan is so different from anywhere else I’ve been, I think it has been helpful to go slow in terms of seeing my surroundings and setting up meetings (even though I wondered at first if it was too slow). Also, now that I’ve done so many interviews in general through the year, I feel like I know how they go. It’s been tough feeling like I don’t have as many revelatory ‘wow’ moments as I used to, either with myself or the project, but I suppose that’s natural. I’m getting answers to my questions that surprise me less and less frequently.

So at this point in the Watson, now that I have many meetings and travels under my belt, I rely less on one-on-one interviews than I used to and more on myself and my observations, trying to pick up on relevant nuances and how they compare to what I’ve seen. I’ve enjoyed this slow absorption of Japan, joining the population by being packed into a rush-hour metro train or making the pilgrimage to one of the many parks ripe with blooming cherry blossoms. I like living this way, spending time with my host family, learning the seemingly irrelevant attitudes – the very safe, low-risk style of life; the strong sense of a common collective; the appreciation for anything cute (kawaii!); the intense corporate culture – that do indirectly affect the way people respond to medical devices and the field of medical technology as a whole.

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Shinjuku

Now that I’ve done my project in four countries, I’m quicker at understanding how cultural trends complicate attitudes towards medical technology, which is good even if it makes interview experiences less novel for me. That’s why I like mixing up “project events” so that it’s not always the same interview after interview by going to trade fairs or even touring the showrooms of big tech companies. Although, one thing that’s nice about interviewing people in this stage of the Watson is that I can add something to the conversation, too. People are curious to know what I’ve learned so far, and now that I’m in my fifth country, it turns out that I have a lot to say! I definitely prefer having an exchange of information rather than a one-sided interview – I feel like I’m giving something back.

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Speaking of Japanese culture…See the young woman he’s holding in his hand?

In summarizing my experience so far to my interviewees, I’ve realized that I’m so impressed with Sweden. It may be order bias with Sweden as my first country, but as a main point of comparison, few countries measure up to it. I thought Japan would blow me away in every project-relevant department – health, technology, quality of life, innovation – but Sweden is doing just as well in those areas, if not better. Japan does have a lot of fun technology, but I don’t think it’s very well integrated with healthcare. Traditional corporate culture and social hierarchies still reign in Japan, and combined with a risk-averse business mindset, that means that the cute robots here aren’t always being used for health applications, and those that are cannot prove that they are making a positive impact on the population. It’s definitely complicated, and it’s been fascinating to see all these contradictions in Japan that I wasn’t expecting – I feel like I’m really getting to know the place.

All that said, the pace of meetings here in Japan is finally picking up. I’ve done three interviews since returning from Okinawa, and I just planned two weeks of solo travel to meet with researchers in Osaka and Nagoya. It’s odd to me that I haven’t done any solo travel in Japan since arriving here – that’s the Watson bug! – so I’m looking forward to going off on my own again.

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Mt. Fuji as seen from the window of the shinkansen bullet train. It took two months of being in Japan for me to see it, and then I whizzed past it at 160 mph!

One thing that’s really hard about being at this point in the Watson is that it is hard to stay unaware of the end. I don’t want to think about going home, but it’s an unavoidable fact that this is the last quarterly report I will write while on the Watson. If I let myself go there, I worry about coming home, getting a job, and adapting to a non-Watson lifestyle. But that’s distracting, so I try not to think about it, and instead focus on how happy I am that it’s turned out so great so far. I have to say that I’m still stunned by how kind everyone is. People, even people I barely know, continue to be unendingly and exceedingly kind to me. That’s one thing I never want to get used to (or worse, come to expect). It’s all too wonderful and strange.

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Speaking of wonderful and strange, this enormous clock was designed by director Hayao Miyazaki (and it definitely looks like something from his films). Four times a day, it grinds, whirrs, and clanks to life on the hour, and it’s so much fun to watch all the little pieces move – like the people in the bottom right tending to the mini fire.

 

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