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Sho Okiyama, doctor teaching AI expert skills for future
Roundtable
TIMOTHY SCHULTZCONTRIBUTING WRITER

Ten years ago, Dr. Sho Okiyama was living
an interesting life. As one of two doctors ina small hospital on the Okinawa island ofIshigaki, his nights were either a flying adventure or a rather boring study session.
The good shifts offered patients, with ahurried helicopter ride to one of the island’s
remote communities. The slower nights saw
the fresh-faced 28-year-old in his small office,studying medical videos online.
It was so unlike his time working in an
ER in Tokyo, where every shift meant a newchallenge and a new chance to learn from his
more experienced senior doctors. Ishigaki
might be slower, but when the challenges
came he faced them alone.
The young doctor’s face clouds a little
when he talks about those nights. “On theslower nights, I had to study. I would think,‘If only I had that surgical skill’ or ‘How can I
have the eyes of (a more experienced) doctor, or the ears of another?’ I wanted to beboth a generalist and a specialist, but thisis impossible. It takes time to become anexpert in all the areas, and I just didn’t think I
could do it within my lifetime.” Acting alone,as the sole physician on an island, made him
acutely aware that all doctors are in someways practicing alone, with the responsibility for their patients’ lives in their hands.

From helicopter to startup

Ten years later, Dr. Okiyama is practicing adifferent kind of medicine. Instead of flyingin helicopters, he is the founder of Aillis, aJapanese medical device startup that builds
AI-powered tools for doctors all around theworld.
Its first product is hardware: a small,purpose-built oral camera that takes a rapid
series of photographs of a patient’s throat
and pharynx.
Its second product is the camera’s software, which analyzes the photos to provide ahighly accurate influenza diagnosis.
“There are minute differences between thedifferent kinds of inflammations within thethroat,” he said. “In fact, the most challenging part of diagnosis is eliminating the otherkinds of infection, which present very subtle
differences in inflammation patterns on thethroat, tonsils and larynx. It is here that mostdoctors have the most difficulty, and thisresults in a very high amount of misdiagnosis. Machine learning can be more successful
in making that distinction.”
Watching him during his appearance
at The Japan Times’ sustainability roundtable series, the fresh-faced, goateed doctor
seemed too young to be changing medicine
itself. Learning more about this soft-spoken
man’s life explains his unique character.
Raised abroad, first in Philadelphia and thenas a teenager in Rome, he returned to Japan
to attend school here. In his gentle, fluent
English, Okiyama described his overwhelming desire to “see the people I was helping
immediately, in front of me, to see theirsmiles. So it seemed that the two choices fora career were either teacher or doctor.” Hechose medical college, which allowed him toSho Okiyama andRoundtable hostRoss Rowbury
discussing thebenefits of artificial
intelligence inmedicine.
YUICO TAIYA FORPHOTOMATE

engineering problem. If this cycle knowledge
could be gathered and stored beyond thetime period of a single doctor’s life, then all of
medicine would improve. But how?

The new tool: AI

The answer seemed clear: artificial intelligence. Okiyama compares the development of AI to humans’ development ofwriting: before writing, all knowledge wascycle knowledge. Just as the written word
allowed for basic information to be recorded,
AI will do the same with the more complex
information of technique. Instead of describing techniques, an AI will perform them.
“There are chess-playing AI these days thatcan beat champions. Even if I read a bookby a grand master, I cannot become a chessexpert the next day. But if I preserve that
grand master’s knowledge and skills in anAI, then the expert’s skills become instantly
useful to me. With a smartphone, I might beable to beat another grand master using thatAI.” Okiyama sees AI as the ultimate tool for
medicine, where the stakes are much higher
than in chess. For a doctor, the disease is theopponent.

Taking risks to help medicine
Sho Okiyama is the CEO and founder of Aillis Inc. YUICO TAIYA FOR PHOTOMATE

graduate faster than his American counterparts, who must first go through undergraduate school.

A new theory of knowledge

It was during medical school and in his practice afterward that he developed a uniquetaxonomy of medical knowledge. “I decided
there are two types of knowledge: ‘stock’knowledge and ‘cycle’ knowledge. Stockknowledge is... information which can beaccumulated and stored, put into libraries.
But there are certain types of knowledge
that cannot be described verbally, which
I call cycle knowledge. Examples of thismight be medical technique, or medical skills

like examination. These skills are learned
through practice and experience, and thistakes time. I can add to the stock knowledge
by publishing a paper. But even If I live to 100
years old and become an expert, skillful doctor, when I’m gone I cannot leave my skills
behind.”When asked which kind of knowledge
is more important for practicing medicine
as a doctor, Okiyama didn’t hesitate. He hascome to believe that a doctor’s skill is 20
percent stock knowledge and 80 percentcycle knowledge. Considering how slowly
cycle knowledge accumulates, and the fleeting nature of acquired skills, improvementof the medical field can be seen as a unique

Such grand ambitions seem to come naturally to Okiyama, but he worries that otherJapanese doctors feel pressure to not takerisks. For instance, fewer doctors create medical startups in Japan compared to the USA, afact that he mourns. In Japan, the prestige of a
doctor’s position in their hospital or practice
is considerable. It can create a kind of pressure to never give that position up, even if
they have ideas for startups or new medical
technology. “To younger doctors, I would tellthem that taking risks is essential to changing
medicine. The risks may not be as big as you
think they are. Even if you fail, you’re a doctor — you will always have a way of earninga living. This is a reason to take risks. Give it ago! That’s my message.”With Aillis’s first two products currently
awaiting approval, Okiyama sees huge

Medical helicopter used by Okiyama to reachout to his patients SHO OKIYAMA

potential for what might come next, bothfor Aillis and for the use of AI in medicine.
“We have plans and beta software for otherdiseases. The throat and pharynx contain somuch rich information. Remember, this is
the inside of the body. We can see the bloodvessels running behind the walls, the inflammatory patterns. The tonsils can tell us if aninfection is bacterial or viral...” He stops himself, a little shy at his own enthusiasm. Okiyama might have big plans, but he is still toomodest to talk big.
More than his ambitions for his own
startup, it is Okiyama’s vision for all of medicine that leaves the biggest impression. OnIshigaki, many of his patients still consulted
shamans, an ancient tradition that manyisland families practice. When faced with adifficult medical decision over treatment orsurgery, shamans provided principled andtrusted advice, acting almost like a partner tothe doctor. “Maybe in the future, a patient’sdiagnosis and options may come from theAI system. And we doctors would be moreon the patient’s side, consulting them.”
At the memory of theislands, Okiyama smiled.
“Almost like a shaman.”Roundtable is a monthly series of Englishlan- guage events organizedby TheJapan Times Cube. For
more information visit https://sus- tainable.japantimes.com/
roundtable

First Ronnie Prize aims to revive Tottori game meat spices up
traditional Japanese crafts
dinner table while curbing waste
Satoyama~AuthenticJapan

MAIKO MURAOKACONTRIBUTING WRITER

JapanCraft21, a volunteer group that aims
to reinvigorate Japan’s traditional crafts, islaunching its first Japan Traditional Craft
Revitalization Contest, also called the Ronnie Prize in honor of an exemplary young
individual and great admirer of Japanese
crafts. The winner will receive a prize consisting of ¥5 million funding for his or her
craft-related project as well as support
from a special team of professional mentors in such areas as business, design, product development and marketing. The prize
funding will be granted incrementally overtime. The winner must meet certain criteria established by the mentors.
The Asia Society Japan Center in Tokyo’s
Minato Ward is co-sponsoring the eventand sharing its networks of people andresources.
The Asia Society is a leading nonprofit
educational institution, founded in 1956 byJohn D. Rockefeller III to nurture understanding and partnerships among individuals, leaders and institutions in Asia and theUnited States, especially in the fields of thearts, business, culture, education and policy.
Since its establishment in 2018, JapanCraft21 has been supporting the efforts ofTomohiro Naito, a young fifth-generation
carpenter and president of Naito Koumuten, in establishing Shinmachiya Juku, aschool offering training in high-level wood
craftsmanship to young carpenters whileproviding them with scholarships. A specialist in wood building restoration, NaitoToday, many traditional crafts struggle tosurvive, due to shrinking demand and a shortageof young crafts people. KAZUKI FUJIMOTO

MAIKO MURAOKACONTRIBUTING WRITER

JapanCraft21 and fifth-generation carpenter Tomohiro Naito aim to halt and reverse the disappearance of Kyoto machiya townhouses by teaching young carpenters advanced techniques ofwood joinery KAZUKI FUJIMOTO

has the passion, skills and determination
to preserve the tradition of machiya-style
houses built with wood joinery and without nails. Through this project, Naito andJapanCraft21 aim to halt and reverse thetrend of disappearing machiya townhousesby teaching young carpenters necessary
skills and techniques, enabling them to startbuilding machiya homes in Kyoto again for
the first time in 80 years.
In addition to teaching a new 18-monthwood joinery course, Shinmachiya Juku
will add two new related courses from Mayof this year for working professionals, one
focused on Japanese bamboo mud wallconstruction, and the other on advanced
Japanese gardening skills.
These are not the only fields in Japanesetraditional culture that are vanishing at an
alarming rate. Production and sales havebeen declining in many categories such as
urushi lacquer, textile weaving and dyeing,bamboo basketry, metalworking, dollmaking, wood-turning and ceramics, due
to a number of factors including shrinking
demand and shortage of successors.
Artists, craftsmen, designers and productplanners in various fields of Japanese crafts
are encouraged to apply to the contest.
JapanCraft21 is committed to making thisinaugural event successful. It will be followed by similar competitions held once or
twice annually as part of its long-term strategy for revitalizing Japanese crafts.
Contest applicants must submit a simple
application form by April 10, outlining
their project proposal for revitalizing a tra-ditional Japanese craft. Contestants must
address the functional beauty of Japanese
crafts as well as the environmental impactof their plans. The application fee is ¥1,000.
The top 50 applicants chosen in the preliminary selection process will be asked
to submit more detailed project proposals along with information regarding theirbackground and experience.
Ten finalists will be evaluated by six
judges: Yuji Akimoto, director of the University Art Museum of Tokyo University of theArts; Shihoko Fukumoto, indigo dye artist;
Eriko Horiki, washi designer and director of Eriko Horiki & Associates; professor
Tsutomu Horiuchi of Tama University;
Masamitsu Saito, collector and authority
on Japanese bamboo baskets; and Reiko
Sudo, founder, director and chief designerof Nuno Corp.
Besides the Grand Prize winner, whowill receive ¥5 million and support froma group of mentors, four runners-up will
also be given an opportunity to meet withthe judges for strategic evaluation of theirprojects going forward. All 10 finalists will
present their project concepts at an awards
ceremony to be held in Tokyo and broadcasted worldwide via the internet.
More information and the application form
can be found at the JapanCraft21 site, www.japancraft21.com.
The Asia Society Japan:
https://asiasociety.org/japan/
about-asia-society-japan

Game birds and animals have been attracting
attention in recent years in Japan not only as
healthy, flavorful delicacies but also as a way
to curb food loss because although many
species are considered pests and are subject
to culling, it is wasteful to just kill them —they are natural resources that can be used invarious ways.
Most Japanese can enjoy game meat onlyat special restaurants, yet “Wild meats canalso be used for home cooking,” chef Takuto
Murota said. “For example, minced venison
can be cooked like ground beef, and sliced
wild boar meat can be stir-fried with vegetables just like pork,” he said on Jan. 20 at theonline talk event Tottori Gibier Roundtable(the French term for game meat, gibier, hasentered Japanese as jibie). The French restaurant he owns in Tokyo’s Shibuya Ward,Lature, is known for Murota’s refined andunique selection of ingredients, including
various wild meats.
The event, which focused on the characteristics and potential of Tottori Gibier, wildvenison and boar meat from Tottori Prefecture, opened with remarks from Tottori Gov.
Shinji Hirai. “Game can be used for variousdishes. It can also be enjoyed at home using
food delivery services. I hope this discussion
will provide an inspiring and refreshing timeto the audience in these difficult times,” heOverview of decommissioning of deer’s meat
WAKASA NIKU KOBO

PAGE: 6Oyster chowder with Boar Bacon TOTTORIPREFECTURE

said.
Tottori, in westernmost Honshu’s Chugoku
region, is the least populated of Japan’s 47
prefectures. “But there are wild mountains
that provide nutritious food and fresh water
to the wild animals running through thewoods,” said Tateki Kawato, the facility manager of Wakasa Niku Kobo (Wakasa Meat
Factory), a processing facility for wild deerand boars in the town of Wakasa in the eastern part of the prefecture.
Hiroshi Miyazaki, the owner and chef ofUmenoi, a traditional Japanese restaurant inTottori, also noted that the muscles of wild
animals grow strong to aid survival, which is
why their fibers are firm and become juicy
and tasty when roasted slowly. Even if one
does not have an oven or other method ofroasting at a controlled temperature, there
are still ways to enjoy venison at home. “Venison remains tender if you cover slices withstarch or flour before frying,” Miyazaki said.
Murota pointed out that processing speed
is also key to producing good game meat.
“No other facilities can process wild meatas fast as Wakasa Niku Kobo does. Thanks
to this efficiency, stress on animals is minimized, making the meat delicious,” he said.
Along with high processing capability, Tottori’s intact tracts of unspoiled land allow astable supply of high-quality wild game.
Miyazaki also noted that what makes
Tottori game meat special is the passionate
producers in the prefecture. He explainedthat there are producers like Japan Wild Boar
Bokujo that are keen to receive feedback
from clients and make constant progress in
improving quality. Murota nodded and said,“The owner understands each client’s preferences and tailors recommendations.”
Japan Wild Boar Bokujo is a farm thatraises wild boars caught young and also pro-Gibier hamburger with various mushrooms
sauce TOTTORI PREFECTURE

cesses boars brought
in by hunters. Kenichi
Tokuoka, the owner ofthe farm, said he aims to keep quality consistent by raising boars for at least a minimum
period of time. “We are also trying to minimize waste by using every part of the body.
The parts that do not sell well, like shins, canbe minced. The skin is used for leatherwork,”
Tokuoka said. Kawato also said deer bones
can be used for ramen broth or consomme.
Murota, whose Lature recently earned aMichelin Green Star — a distinction given
to restaurants that take a greener and moresustainable approach to gastronomy — said
that those in the food industry are responsible for taking into consideration issues suchas food waste. He explained that consuming
wild game meat in itself leads to less foodwaste because most such animals have beentreated as merely pests and are otherwise
thrown away after being hunted. “At thesame time, Japanese game meat can only beenjoyed in Japan due to export restrictions. It
can be a special attraction for inbound tourists who look for local delicacies,” he said inconcluding the talk.

Tottori Pref., Chugoku region, is Japan’s least
populated prefecture GOOGLE MAPS

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