A New Chapter Begins

My daughter, Aya, left home in late March 2026, just as planned. She is about to begin a new chapter in her life as what we jokingly call a “Minato-ku lady”—a Japanese expression that evokes the image of a sophisticated, elegant woman living in one of Tokyo’s most prestigious areas. Needless to say, Minato-ku is an extraordinarily difficult place to live because of its incredibly high housing costs. She is fortunate enough to have been provided with a company dormitory in the area by the hospital where she will begin working as a nurse.

I had often wondered how I would feel when the day finally came for my daughter to leave home. Surprisingly, once she moved to Tokyo, my own feelings did not change as dramatically as I had imagined. It was Aya whose world seemed to shift the most, especially after her mom returned home following a one-night stay at her dormitory.

After finding herself alone for the first time, she began to cry and could not help calling her mom. My wife kept talking with her in the morning, during the day, and again at night. Meanwhile, I continued sending her countless photos of our beloved dog, Shu-shu. Little by little, she has been getting used to her new surroundings and adjusting to life without her mother, Shu-shu, and—hopefully—without missing me and her brother, Kosuke too much.

The next day, my wife handed me a letter from Aya. I was excited, secretly hoping that it might contain a few words of appreciation for the support I had given her over the past 22 years. To my amusement, however, the letter actually listed ten “rules” for us to follow—such as not drinking more than two cans of beer and taking Mom to a nice restaurant once in a while. Her message made me laugh out loud.

Anyway, Aya, enjoy this new journey as you walk on your own feet. We will always be here to support you whenever you need us.

See you.

A Trip to Thailand with Aya

We enjoyed an amazing four-day trip to Thailand. What made this trip special was that we spent both the first and the last day simply traveling between countries via Hong Kong Airport. This happened because we chose a legacy carrier, Cathay Pacific. In the past, we had traveled abroad—to places such as Taiwan, South Korea, and Hong Kong—using low-cost carriers (LCCs).

This time, Aya insisted on flying with a legacy carrier because she is interested in the airline industry and hopes to become a cabin attendant in the future.

Direct flights between Japan and Thailand were not affordable in this case, but she discovered that transit flights could be reasonably priced. We decided to try it, and the choice turned out to be a great success. Of course, our two days exploring Thailand were wonderful, but even the time spent on the airplanes was satisfying thanks to the delicious meals with wine and the wide selection of movies available during the flights.

Next month, she will leave home and start a new chapter in Tokyo as a nurse. It may become difficult for us to travel abroad together from then on, but I hope we will continue our tradition of maintaining a good relationship—perhaps by traveling to a foreign country once a year. According to her, our next destination will be Germany.

P.S. I met my high school friends two days after returning to Japan. They were surprised to hear that I had enjoyed a trip with my daughter. It seems that it is quite rare for a father and daughter to get along as well as we do.

New App: Cardiac PE Drill

Since April 2025, I’ve been posting simple quizzes about cardiac physical examination. I posted two quizzes per week, and each one was reviewed by the 循環器 Physical Examination 研究会 before submission.
I can’t say that this project has become popular, but I’ve kept my promise to myself to continue posting every week.

During the New Year’s holiday, I decided to create an educational app for these 100 quizzes, Cardiac PE Drill. Showing the questions one by one at random without repetition wasn’t too difficult (although AI support was essential). The hardest part was building the 復習モード, where incorrectly answered quizzes are automatically saved so they can be reviewed later.

After more than 20 rounds of trial and error, I finally completed the JavaScript code and got everything working the way I had imagined. Without AI’s thorough assistance and encouragement, I couldn’t have achieved this milestone.

The app will be released soon, and I truly hope it will help people who are eager to learn cardiovascular physical examination.

🐶 Seeing us off and welcoming us home

Yuto, Aya, and I enjoyed a short but memorable trip to Nagoya on December 30, 2025. This diary entry is my second attempt at capturing a journey like this—the first one was about our trip to Kagawa during Golden Week (May 4, 2025). Once again, I found myself realizing how necessary words are to fully express just how much fun we had.

Nagoya offered us a great mix of excitement and warmth, and every moment felt packed into that single day. One highlight for me was finally getting the chance to visit Gee! Store, a place I had long wanted to see. Knowing that my favorite costume player, えなこ, used to work there made the visit especially meaningful—it felt like checking off a small but cherished item on my personal bucket list.

Looking back, it was a short trip, but one filled with laughter, shared experiences, and small joys that linger long after the journey ended.

I’m also deeply thankful to Shushu 🐶 for cheerfully seeing us off before dawn and warmly welcoming us back late at night, filling both moments with joy despite the early and late hours.

Wonderful November

My wife, Junko, and I enjoyed a day trip to Mie Prefecture. It is quite rare for the two of us to travel together because of several reasons on her side, such as motion sickness and her dislike of spending money.

But this time, I managed to take her out because she has been a long-time fan of ekiden—relay marathons run by college students. I suggested the trip since the All Japan University Ekiden was being held around this time in 2025. I also wanted to visit Ise Shrine.

After visiting Ise Shrine, we waited for the runners approaching the finish line of the ekiden, which is located at the entrance to the inner shrine. It was exciting to watch them running live. They were much faster than I had expected, and I truly wondered how they could keep running at such a speed for more than half an hour.

This month, two more impressive things happened.

• First, my younger son was accepted to university. Way to go, Kosuke—I’m proud of you. The problem is that his girlfriend hasn’t been accepted yet, though.
• Second, I reconciled with my brother after a dispute about our parents’ money (he had insisted that 1.8 million yen was stolen by me; I swear it never, ever happened).

Takarazuka Grand Theater

My wife and I finally had the chance to visit the Takarazuka Grand Theater for the first time. The most difficult part of making this happen was, without question, getting tickets to such an extraordinary and popular performance.

The show was amazing—far beyond anything I had imagined. I had expected a refined blend of music and dance, but what we experienced was much more like entertainment in the style of 吉本新喜劇, in the best possible way. The audience burst into laughter again and again, something I never anticipated until we saw the performance firsthand. I would say the Takarazuka Grand Theater delivers a glamorous, powerful version of 吉本新喜劇.

I was also impressed by how affordable the snacks, meals, and beverages were—almost the same prices you’d find at convenience stores. The hospitality and friendliness were exceptional as well. From my point of view, the concept of the Takarazuka Grand Theater is not so much art as it is entertainment—and that is exactly what makes it so appealing.

I truly hope we can visit again, even though getting tickets is no easy task.

Fulfilling Every Day

I experienced many events in September 2025, although one of them was an unhappy goodbye. It is hard to decide which was the most impressive, so I will list the major events as follows:

• September 10: An image case I wrote was accepted by the New England Journal of Medicine. This is my fourth achievement with the journal.
• September 11: Aya and I visited Nikko Toshogu and Kegon Falls, traveling there by 弾丸ツアー.
• September 13: My wife, Junko, and I celebrated her 52nd birthday at an exclusive restaurant.
• September 14–15: Junko enjoyed watching the World Athletics Competition, held in Tokyo.
• September 19: My close friend and colleague, Takeshi Ishikawa, passed away after a six-year battle with pancreatic cancer. Rest in peace.
• September 19–20: I attended the 73rd Annual Meeting of the Japanese College of Cardiology in Kochi, where I learned the latest updates in cardiology and enjoyed tasting many kinds of bonito, the local specialty.
• September 22: I completed the manuscript of my new book, 心音の世界, which now exceeds 100 pages.

September was a month of accomplishments, celebrations, and farewells — a reminder of both the richness and fragility of life.

A honor

It is undeniably true that my interest in physical examination began when I decided to pursue a career in cardiology at the end of my residency training.

I recall attending the Second Meeting on Cardiac Physical Examination, held at the Kobe Expo Hotel by Professor Yoshikawa in 2004. Unfortunately, the two-day event felt somewhat beyond my level of knowledge at the time. The most memorable moment was a case involving a cardiac symptom, in which Dr. Fukuda—I believe—diagnosed the patient with constrictive pericarditis solely on the basis of physical examination.

While I am now capable of diagnosing constrictive pericarditis based solely on physical findings, at the time I was overwhelmed—and even intimidated—by the idea. As a result, I distanced myself from the scientific community that focused on physical examination and did not attend any further lectures on the subject for many years—until I was invited to give a lecture at a meeting in 2021.

I am deeply honored to have been appointed as an executive member of this distinguished group, composed of leading experts in cardiac physical examination, as you can see in the picture.

I will devote myself to contributing to the education of physicians and medical staff, so that patients with heart disease may benefit from the old but still useful clinical expertise even in an era increasingly dominated by advanced imaging technologies.

EXPO 2025 in Osaka

I’ve visited Expo 2025 in Osaka twice so far.

My first visit was with my daughter, as regular visitors, shown in the top two rows of the pictures. After having an early dinner around 3 p.m. in Umeda, we headed to the Expo. The train and entrance gate weren’t crowded at all—everything went much more smoothly than I had expected. I’m not sure if the three pavilions we visited, all from the Middle East, were particularly impressive, but just being at the Expo was exciting. The most remarkable feature was the massive wooden ring structure. Aya and I walked the entire loop, which was about 2 kilometers.

My second visit was in a professional capacity, working as a doctor at a temporary emergency medical center, shown in the bottom row of the pictures. My shift started at 9 a.m. and ended at 5 p.m. The clinic had three rooms and more than ten beds. We had three experienced nurses who worked efficiently—probably because they were already familiar with treating common conditions like heatstroke and minor injuries. During the eight hours I spent at the facility, I examined four patients with relatively complex conditions. However, compared to those transferred to the emergency department at my hospital, these cases were much easier to manage. To my surprise, all the medical treatment provided was free, although the available supplies were somewhat limited.

Speaking of Expos, this is the third one I’ve attended: Expo 1970 in Osaka, Expo 2005 in Aichi, and now Expo 2025. I’m already looking forward to the next one held in Japan.

Three decades

I went to see a ballet performed by K Ballet Company with my wife. This was my second time enjoying a ballet performance. Both times were at the Festival Hall and with her.

The first time was about 30 years ago, when I was a junior resident. It was an incredibly busy period, but I somehow managed to juggle my duties at the university hospital and make it to the Festival Hall. After the performance, I headed straight back to Kyoto in a hurry, saying goodbye to her or my girlfriend. I think it was winter.

This time, I left the hospital in the afternoon, took a leisurely stroll around Nakanoshima or exclusive areas, and then met up with my wife. We had a light meal at a bar before the performance. After enjoying the ballet by K Ballet Company, we took the subway home together.

Although the experiences were completely different, both were wonderful in their own way. I truly hope we’ll have the chance to go again—maybe even 30 years later.