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But Japan is now afree democracy, has few overt controls over the media, and is famed for its high technology. All Japanese study English as children in grade school, and tens of millions of them have traveled abroad. In addition, Japan is rich. It is a situation verging on the incredible that modern Japanese would lack access to up-to-date information or business opportunities within Japan. And yet the flow of refugees continues.
It begins with doctors. The National Institutes of Health (NIH) in Bethesda, Maryland, have more than 350 Japanese doctors in residence at any one time. Each doctor represents the department of a certain hospital in Japan, and when his three-year term is over, his department sends a replacement, a system that has gone on for decades. The reason is that basic research in Japan is understaffed, weakened by bureaucratic inertia, and limited by a lack of freely shared and reliable data.
Not all of these doctors return to Japan. Many of the brightest and most innovative remain in the United States. Dr. Kakere Ken, a specialist in cancer cell division, has been at NIH since 1967. «The reason I stayed at NIH is because I could freely pursue basic research [here],» Dr. Kakere says. «Creative work is valued in American medical research. In Japan, I could only have researched in one narrow category. Also, in [Japanese] institutions, with their vertical hierarchies, there is little exchange between people-this is another difference from America.»
Doctors have symbolic importance because they exemplify the process by which Japan learns from the West. During the Edo period, medicine alone was officially sanctioned as a field of foreign study; scholars flocked to Nagasaki to learn skills from the Chinese and the Dutch. One could say that medicine is the only truly indispensable modern technology. Many of us might enjoy taking a journey to the past for the experience of living with candles and traveling by horseback, but who would be willing to forgo modern medical treatment? From that point of view, medicine is the queen of technology, and it was indeed the only thing from the West that premodern Japan really wanted. Therefore it is all the more surprising that today, nearly one hundred and fifty years since Commodore Perry arrived, medical advances still do not originate in Japan; they continue to come from the West, and Japanese doctors continue to flee to the West and stay there. As one Japanese newspaper put it, «In the field of basic research, human exchange between Japan and America is basically a one-way street-Japan absorbs knowledge from the United States.» Dr.
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