RIKEN Center for Brain Science in Japan

RIKEN Center for Brain Science
(There are many more buildings on the campus)
Photo from here

I spent this past week in Japan for a one-week summer lecture course through the RIKEN Center for Brain Science. They hold both a one-week lecture course and internship course every summer for students from all across the globe. For the students in the one-week lecture course, we were provided with most expenses covered by the organization. (I learned that they also receive support from IBRO, the International Brain Research Organization headquartered in Paris). These expenses included hotel accommodations and transportation (to and from Tokyo, and to the hotel).

This was an invaluable experience and I’m beyond grateful for this opportunity to travel to Japan to present my research, learn about the research that other young and established neuroscientists are working on across the globe, and explore a little bit of Japan during the first week of July. I was one of 2 medical students selected for this program (2 students were obtaining Master’s degrees and the remaining 28 students were in PhD programs). I presented the work that I’ve been doing with an epileptologist at my school through the Loyola University Medical Center. We have been elucidating the neuropsychiatric side effects of perampanel (fycompa), a second-line anti-epileptic medication for patients with focal and secondarily generalized tonic-clonic seizures.

The lecturers selected for the summer course are well-known neuroscientists from all across the globe. For example, we heard from the PI (principal investigator) of a lab in Israel who was the first to discover hippocampal space cells in bats in his efforts to understand the neural basis of behavior. Another PI at the RIKEN Center for Brain Science developed a number of technologies (fluorescent probes) that are widely used in a number of other labs in order to investigate the functions of specific signaling mechanisms implicated in various neurological disorders, such as Parkinson’s and Alzheimer’s.

Again, I can’t express enough thanks to RIKEN and IBRO for creating this opportunity for students around the world.

Okay, now I’ll discuss a few things regarding the differences between Japan and the U.S., and one unexpected stressful event that I encountered on my journey to and from Tokyo. Everything ended up working out though, thankfully.

A few differences between Japan and the U.S.

These are a few differences that were salient to me and that I can think of off the top of my head. I’m sure I’m probably missing a few other big ones, so if you are familiar with Japanese (and U.S.) culture, please feel free to add!

Everything is TINY. And I mean everything: the meal portion sizes, the cups, the hotel rooms (well, at least the ones we stayed in), the soda cans (see to the right), the snacks…. I’m used to everything being so big in the US. I remember on my flight from Shanghai to Tokyo, I was served a cup of water that was literally half (or even a third) of the cup size that is typically served on domestic U.S. flights. I remember staring at the cup for a while, then finishing the water in two gulps.

·       There is quite a bit of strictness in Japanese culture. A couple of big examples are the signs up in the subways that say “No running” and instructions for people to form lines before getting on the train. Needless to say, this is very different from how things are done in the New York subway system, for example. No one forms lines to get on the train. You just get on. And people are running all the time. (People were running in Japan too, but not as many as you would see here in the states).

·       The toilets are high-tech. I have never seen toilets like this before. I did not touch any of the buttons during the first part of my stay because I had no idea what they meant, but after hearing some of the other students talk about the features, I decided to try it out for myself. These toilets are unique because you can press buttons that will essentially squirt water into your private areas once you are finished using the bathroom. This “cleaning” option is different for men and women, and can be adjusted to fit your own anatomy. There is also a drying feature.

·       Japanese food has a much milder taste than American food in general. We love to douse our meals in salt, pepper, sugar, and other spices. Japanese seasonings and flavors tend to be more moderate. Overall the meals are healthy!

·       Bowing down. In Japanese culture it is commonplace to bow down to someone else out of respect, especially for greetings or expressing thanks. You may see a slight nod of the head, but more often people will bend at the waist. The most common phrases/words that I have learned were:

• Hello - Kon'nichiwa
• Good Morning - Ohayō gozaimasu (O-HI-OH GO-ZAY-MAS)
• Thank you - Arigatō gozaimasu
• Do you understand English? – Eego wakarimasuka? (EGO WA-KA-REE-MAS-KA) which I only used once. I felt that it might’ve been rude to ask someone that, but it was a recommended phrase to learn in a youtube video that I watched.

Flying into Shanghai

Stressful events during the journey
When I left Chicago, I flew first into Shanghai. I had a 13-hour layover there. Upon arrival, I was told that I could not check in for my next flight to Tokyo until the following day. One of the airport workers recommended that I check in to a hotel 15 minutes away from the airport. The stay would only cost $40. I agreed. Once I arrived and checked into the hotel, I realized with horror that I forgot to pick up my poster tube at the baggage claim. It contained my research poster for the poster session at the conference. We'd been instructed a million times through e-mail to bring it with us. China Eastern did not allow me to take it onto the flight because it would take up too much space in the overhead bins, so I was asked to check it as a second luggage (free of cost).

I was not used to traveling with anything other than my regular suitcase and my large Vera Bradley carry-on bag which I take everywhere with me, so it completely slipped my mind to pick up the tube. I tried to connect to the hotel’s WiFi to call the airline free of charge on my g-mail account. I wanted to confirm that they had my poster tube and that I could pick it up the following day when I returned to the airport. The WiFi didn’t work at all for me, and I was without service, so I rushed to the front desk of the hotel and asked if I could call the airline on their telephone.

The woman couldn’t understand a word I was saying. I don’t speak Mandarin, and she basically didn’t speak much English. We ended up using a translator app on her phone. When I asked if we could look up the number for the airline on her cellphone, she said through the translator app, “I don’t know how.” That was her answer to most of my questions. I tried not to grow frustrated with her. My immediate thoughts were, “Just look it up on Google!!” (I did not remember until my journey back that mainland China essentially blocks the use of everything on people’s personal electronic devices, including Google. Yahoo works, though. However, most people override this block by connecting to special VPN apps, but I wasn’t sure if this woman knew how to do that).

Eventually, we obtained the number (I'm not sure how), but I ended up waiting for a very long time on the phone. No one picked up.

“Sorry,” the woman said, hanging up the phone for me. “Try tomorrow when go back to airport.”

I agreed. I was growing tired anyway. The 14-hour flight from Chicago took a lot out of me. “Xièxiè [thank you],” I told her. 

At the airport the following day, things became even more stressful because of the language barrier. I first stopped by a China Eastern customer service desk and asked where I could speak with someone about the poster tube I accidentally left on the baggage claim yesterday. They sent me down to the first floor.

I went down to the first floor and stopped by another service desk. The woman told me to go back up to the third floor. I said, “No, I’m sorry, I was told to come down here.” I noticed that the China Eastern baggage office was located on this floor as well, but there was security that prevented me from going over to that area of the airport. 

I tried to explain my situation once more to the woman, who said I needed a boarding pass before I could pass through security on this floor and speak with the baggage claim office.

So I went back upstairs, waited in line for 45 minutes to check in to my flight to Tokyo, and asked the man who checked me in about the poster tube that I left behind yesterday. Guess what he did? He sent me downstairs.

I went back downstairs to the same desk, and told the woman that I obtained my boarding pass and was sent down here by a worker upstairs. She told me to go back upstairs and speak with another help desk. "I call the office already and they no pick up. You go upstairs and speak to desk there."

By this time I grew very frustrated. I felt that no one was trying to help me, and it seemed like everyone’s goal was to simply get rid of me and pawn me off to someone else. I had had enough, but I remained calm even though I was churning with agitation on the inside.

To make things worse, the woman at the service desk on the first floor made no effort to hide her own annoyance with me. She demonstrated the worst attitude that I’d ever encountered in any customer service professional. I was shocked by her rudeness; I’d done nothing to deserve it. I was the one who should have been irritated because no one was helping me! This whole situation had been a colossal waste of time, and boarding time for my flight to Tokyo was quickly approaching. I really needed my poster for the conference.

After the woman sent me back upstairs I ignored her instructions and walked directly up to one of the security guards to request entry into the baggage claim area. I wanted to speak with someone in the office. The security guard told me to wait a moment, so I nodded and stood off to the side as he continued screening the IDs of airport staff through this "Staff Only" entry. After 10 minutes of waiting and no communication from the security guard (not even a glance), I realized that he had no intention of helping me. “Are you kidding me?!” I wanted to scream. I glanced at my watch. 15 minutes until boarding time.

I went back to the service desk to once again ask the woman if there was any way possible that I could speak with someone in the baggage claim office. She called the office, finally reached someone, and this individual met me in person with my poster tube. FINALLY.

If I spoke fluent Mandarin none of this would’ve happened, I can tell you that. However, you’d expect that workers in an international airport (which receives millions of overseas passengers every year) would have a stronger command of the English language.

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I think I will end with this story. I’m grateful that everything ended up working out in the end.

I never thought I’d say that I’m actually looking forward to returning to Chicago to study for my board exams.

Thanks so much for reading!!

Visiting family in Jamaica

I spent five days in Jamaica at the end of June visiting my mother’s side of the family. My mother grew up in Spur Tree, a rural community in the parish of Manchester. This trip was a wonderful opportunity to spend time with the family (including my grandmother, great-aunts, great-uncles, and family friends), learn more about our rich history, and be immersed in the culture while living in the community for a few days.

Diagnosing family members

The MCP and PIP joints are classically affected in
rheumatoid arthritis. Photo from here

While there, my great-aunts and uncles continued to express how proud they were of me for pursuing a medical degree. I found myself inadvertently making diagnoses left and right, which was especially easy to do coming off the Family Medicine clerkship. My aunt came to me first with complaints about joint pain in her hands. Upon further questioning, the history seemed to fit the description of rheumatoid arthritis, with the pain most prominent in the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints. She also demonstrated slight ulnar deviation of the MCP joints (her hands tended to fan outwards away from her body). See photo below.

Ulnar deviation of the MCP joints in rheumatoid arthritis.
Photo from here

I recommended that she take a non-inflammatory medication like ibuprofen for the pain and encouraged her to see a physician in the town for a more thorough evaluation. She refused to see a “Jamaican” physician and preferred to wait until her next trip back to New York to see her physician there. I also noticed that a couple of my uncles had the classic Bouchard and Heberden nodes of osteoarthritis in the PIP and distal interphalangeal (DIP) joints of both hands. 

Photo from here

I didn’t think it was appropriate to bring it up out of the blue (“Oh by the way Uncle so and so, your hands are looking a bit mangled these days.”) They have upcoming visits with their physicians and hopefully will have these concerns addressed then.

One of my family members also expressed having a poor appetite for the past couple of weeks. This has also been in the context of a few significant stressors so I immediately became concerned about possible depression. I’d completed a number of PHQ-9 (Personal Health Questionnaire) depression screenings in the Family Medicine clinic recently, and poor appetite is a symptom to look out for as having occurred in the past couple of weeks. The next day I gently mentioned the poor appetite to my family member, and upon further discussion I was no longer concerned about depression. It certainly helps that this family member is surrounded by wonderful family and friends, which are protective factors.

There was another random instance when my mind began churning with concern over a situation that occurred years ago. During dinner one day, my aunt shared a story about our cousin who gave birth to her first child a number of years ago. In the two days following the birth, she suffered from an awful headache. I immediately thought of a possible bleed (post-partum hemorrhage) in the brain, though she did not suffer severe symptoms (according to my aunt), and the headache eventually resolved. I was so surprised that she never paid a visit to the emergency room for further evaluation.

The Baker family history (brief)

Anyway, let's stop the medical talk and move on to my family's interesting history. To the right is my legendary great-grandmother, Mrs. Frances Ernestina (“Miss Tina”) Baker (also known as “Mama” to her descendants), born September 1, 1904 in rural Nuttingham, Manchester, Jamaica, and passed away at the age of 107 in August 2012. Everyone in the community knew and respected her. She was a powerful matriarch who gave birth to and raised 10 children. She also raised four grandchildren, including my mother. I’m grateful to have met my great-grandmother in her 90s when I was younger.

It’s incredible to hear of her story from my aunts and uncles as they share their memories of growing up with her. Mama was a strong disciplinarian; she did not mess around. You knew not to cross her, or else you would get whipped with whatever she could get her hands on (usually a stick haha). My aunts and uncles have an abundance of stories about her scary beatings. But you know what? (And I know not everyone will agree with this) – Those beatings helped build their character and whipped them (literally) right into shape. I honestly believe that many children are not disciplined enough growing up, and as adults they are more likely to run amuck and get involved in catastrophic situations. (I’m speaking specifically about American children from what I’ve seen in my own experience growing up in the school system here).

My mother's elementary school: Fairfield Primary School
in Manchester, Jamaica

I visited Mama’s birthplace and her parents’ (my great-great grandparents’) burial ground in Nuttingham, as well as her own burial ground at the Ebenezer United Church where my mother, aunts, uncles, and cousins attended every Sunday as children. I also visited the elementary school and high school that my mother attended.

It has been incredible to experience the cultural context in which my mother was raised. It is nothing like the cushy, comfortable lifestyle that tourists may experience at the resorts near the beaches in Montego Bay or Negril, for example. When I told my friends and colleagues that I was going to (or recently returned from) Jamaica, the beaches must’ve been what they imagined. I’ll tell you this – that is not "real" Jamaica at all. The last time I visited family in Mandeville, Jamaica was 6 years ago. This time around, I admit I again experienced a little bit of a “culture shock” especially with regards to:

·    the bathing (there is no hot water from the spigot so you need to boil the water and mix it with the cold water in a basin to bathe)

·    driving on the roads (it almost seems like a free-for-all out there; on some of the roads in Mandeville there is no clear single or double solid line separating the left and right sides), and

·    the walks through the marketplace in Mandeville (some people will stare at you and automatically identify you as a foreigner; it doesn’t matter if you’re black and haven’t said a word for them to hear that you don't speak patois).

During my layover in Fort Lauderdale, FL on my way back from Kingston, I had a long chat with my mother on the phone. She mentioned that she wouldn’t trade her upbringing for anything in the world, not even for the upbringing of her kids. My siblings and I, born and raised in the U.S., grew up more privileged than our parents. We didn’t have a lot growing up to begin with, but my parents grew up with even less, especially my mother. My mom was raised in the 60s and 70s in rural Jamaica without electricity (they did everything by candlelight in the early mornings and late evenings), plumbing (they used outhouses and bathed in a big metal tub), telephones, or cars (they walked everywhere, including to school and church (which were 4 and 5 miles away from home, respectively). My mother loved it and hopes to return to her home and spend the rest of her life there.

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Thank you for reading!!