Hibiki Yamazaki

Suicide is the elephant in the room in medicine. We rarely speak about it openly, yet it remains a silent epidemic, among our patients, and tragically, among physicians themselves. I first encountered this reality as a medical student in Tennessee in 2022. One of my earliest patients was not much younger than I was. Because we were close in age, I felt we connected quickly. We spoke about his struggles, and I thought I was helping him. But what lay beneath the surface was something I could not see.

When we think about palliative care, our first instinct is to picture pain medications, symptom checklists, and clinical protocols. But for patients with terminal brain cancer, the reality is much more complex. As speech declines, as motor function deteriorates, and as identity itself feels threatened, the greatest need is not always more medicine; it is meaning, connection, and dignity.

The United States and Japan, while separated by geography, language, and culture, share more in common than first meets the eye—particularly when it comes to health care. As post-war democracies that developed robust medical infrastructures in the latter half of the 20th century, both countries have grappled with similar challenges: Aging populations, rising costs, workforce burnout, and persistent health disparities.