By Yoko Kishi, MD, PhD

I appreciate being selected to write for the February edition of ASSH Perspectives. Looking back on my life, I realize that there were four miracles that led me to four great doctors. When I graduated from medical school in Japan, there were no opportunities for a woman doctor to become a surgeon. I chose the department of anesthesiology to learn the respiratory and systematic management first. Actually, I was the only woman doctor (I was the second female anesthesiologist). Since I had been in charge of anesthesia for many babies with congenital malformations, I began to think that I wanted to be a doctor who could perform surgeries that would maximize the child’s expected abilities. But the hospital where I worked did not have a department of plastic surgery. So I decided to learn skin surgery in the department of dermatology. The chief director, Dr. Tetsuro Sugai, understood my passion for surgery to train two days a week at the hospital that had the first department of plastic surgery in Osaka. That was the first miracle. He always praised and applauded me for my work. About one year later, when I knew the new department of plastic surgery opened at the Kansai Medical University, I decided to visit there for a job interview.

At Kansai University, my fate was sealed when I met Dr. Kozo Ishikawa, who was very famous for the classification of the subzone of the fingertip injury. That was the second miracle. I was very impressed by his excellent work, but the following year he moved from Kansai Medical University to Kyoto University. Therefore, I tried to have discussions with orthopedic surgeons and learn the anastomosis of the amputated fingers at Osaka University. One day, the doctor at the department of emergency asked me to perform the anastomosis of the amputated fingers because there was no specialist. My answer was absolutely YES because I believed that jobs that were hard and not popular for men were the ones that were rewarding and where women could be fully active and I didn’t want to lose any opportunity. The success rate of anastomosis was almost 100% except for the index finger over a two-year period. But I was still far from achieving my first dream of performing surgery on children with congenital malformations.

At that time, one of the famous departments of plastic surgery for congenital malformations of the hand was at Jikei University School of Medicine, so I asked Professor Tadao Kojima. It just so happened that I had a presentation at an annual meeting organized by him, which was reviewed and passed. That was the third miracle. My first visit to the annual meeting of ASSH with him was at Dallas, Texas. I requested to visit the famous children’s hospital after the meeting, and he arranged a brief visit to Dr. Marybeth Ezaki’s office for me. That was the fourth miracle that changed me for the better. A few years later, she became the greatest mentor of my life. As you know, she is the first female chairperson of ASSH meetings. She is not only one of the best hand surgeons worldwide, but also is kind and passionate, and these qualities really impressed me. The two years that I spent at the Scottish Rite Hospital for Children proved to be extremely valuable. Dr. Peter Carter gave us the excellent “the 2:4 rule” – “to: for rule”, which states that “lots of operations we can do to the child…but we should try to do only operations for the child.” I still continue to repeat his words to our students and residents.　

My life has not been smooth, and I have always faced great obstacles, but if I believe that my wishes will come true, and if I never give up and work hard, and I do not forget the basics of working for others, then I can believe that miraculous opportunities will come my way and my wishes will come true. Helen Keller said, “After all, what you want is going to get the true knowledge, anyone must climb alone the mountain of tribulation, more than there is no royal road to the summit, it is I realized that I must climb while I meander.”