A farewell letter to a friend (Masatoshi Takeda) on the day of his retirement

Dear Masa,
This is a very special time for you after serving for many years as Professor and Chairman of our Department of Psychiatry, where both of us have been educated as good persons, physicians, psychiatrists, and scientists devoted to scrutinizing the secrets of the human brain and its disorders.

Retirement is not a claudication; it is not the end of a career; it is just a transition from one condition to another new one of superior relevance; it is a movement of power; it is a subtle application of the First Law of Thermodynamics by which energy can be transformed from one form to another, but cannot be destroyed. This is the time in which you begin to transform your productive life into a relic of wisdom and experience. It is the beginning of a new stage in your life.

During these days of honors and celebrations with your colleagues, classmates and pupils, possibly your mind may fly back for half-a-century to see the film of your life as a son, a brother, a student, a friend, a husband, a father, a psychiatrist, and a professor; with movie sequences of quite different colors and sensations: happiness, pain, success, disappointment, gratitude, glory… Life is like that, a combination of multicolored memories which define our ability to cope with our own destiny and to overcome our personal miseries. Your life is rich in many instances, and I feel so proud of you as a friend or a gaijin brother who cared deeply about all your life events over the past 30 years or more.

On such a date as this, on which you celebrate your retirement, I would like to tell you that for posterity, when future generations evaluate your job at Osaka University, in my opinion as important as the number of papers you have published will be the influence of your personality and your honesty as a distinguished university professor. Our professional life has an end, but our work and the impact of our lifestyle and creative thoughts are our best legacy. Actions speak louder than words. Please remember the classical saying of the French writer François-Marie Arouet (Voltaire)(1694-1778): “the best is the enemy of the good”, or that of the English statesman, the Earl of Chesterfield (1694-1773): “whatever is worth doing at all is worth doing well”. Both phrases are good examples of what excellence is. The road to excellence is the path that every good professional should follow.

On a day like this, I would like to tell you something similar to the eloquent appeal that Giuseppe Garibaldi (1807-1882) made to his soldiers after the liberation and unification of Italy: “We must now consider the period which is just drawing to a close as almost the last stage of our professional resurrection (this modification is my own), and prepare ourselves to finish worthily the marvelous design of future generations, the completion of which Providence has reserved for this fortunate age.” I would add, Japan owes to you an undertaking which has merited the applause of your colleagues and the scientific community as well. That is a lot, especially if you compare the praise of your colleagues with the comment by George Bernard Shaw (1856-1950) on his 70th birthday: ”curiously enough , the only tribute ever quoted or remembered to-day is the tribute of the bricklayer, who said ‘I like the man as well as anybody did this side of idolatry’”. When you were a young man and took the turning that led you into the Department of Psychiatry, you took the right turning in every sense. You have served your institution loyally and you’ve devoted your whole life to medicine, psychiatry and scientific research. You have been loyal to your country and your people. You’ve been a good citizen, a good professional, a good father and a good friend. All of us are very grateful.

To celebrate this transition, please take a rest in your busy life. Enjoy every sunrise with your family; and in your secret prayers do not forget to be thankful to Nature every nightfall for surviving one more day, for being useful to your people, for being able to give us a part of yourself. Remember that in the end, only those who share our genes will stay close to us, physically or spiritually. Our family is the final link with the earth which will cover our mortal remains. On many occasions, due to the nature of our professional compromise, we have deprived our families of our presence, our love, our attention, our tenderness. Our children had the right to complain about many absences, when our minds were occupied by science, duties, and professional distractions. Now you have the opportunity to return to them some of those old debts. If we do not do this, we will be forever in their debt. That is the price we have to pay for our omissions. However, in your case, your children must be very proud of you because at their critical ages you were firm as a father in adverse circumstances when death knocked on your door. That is something that they will never forget. Even so, please give them the satisfaction of enjoying your maturity and the emotional stability of your present life. Be prepared to be a great grandfather.

Retirement is a good time to be with your friends, to make new friends and to reacquaint yourself with the simple things in life that help us be a little happier. Confucius (551-479 BC) said “have no friends not equal to yourself”; and the French abbé and poet Jacques Delille (1738-1813) pointed out that “fate chooses your relations, you choose your friends”. Ralph Waldo Emerson (1803-1882), the US poet and essayist, used to say that “a friend may well be reckoned the masterpiece of Nature”; and Samuel Johnson (1709-1784), the British lexicographer, left an interesting thought: “If a man does not make new acquaintances as he advances through life, he will soon find himself left alone. A man should keep his friendship in constant repair”. The recommendation of George Washington (1732-1799), the US statesman, is also useful: “Associate yourself with men of good quality if you esteem your own reputation; for ‘tis better to be alone than in bad company”. It is very true. Sometimes loneliness helps us to rediscover ourselves.

Let me dedicate a part of this letter to our main commitments: medicine and science, the lovers who abducted a great part of our lives. There is an aphorism by August Bier (1861-1949) which establishes that “medicine is like a woman who changes with the fashions”. Although ”among the arts, medicine, on account of its eminent utility, must always hold the highest place”, as Henry Thomas Buckle (1821-1862) pointed out, the reality is that over the years of our medical experience we have passed through deceptive times with unfounded promises of success in our fight against Alzheimer’s disease, in terms of treatment, and our consolation may be our humble contribution to the better understanding of the pathological background underlying this devastating disorder in our society. In this regard, it is likely that Celsus (25 BC-50 AD) was right when he stated that “the Art of Medicine is in need really of reasoning… for this is a conjectural art. However, in many cases not only does conjecture fail, but experience as well”. Similarly, Oliver Wendell Holmes (1809-1894), the US writer and physician, in his Medical Assays, referring to Medical Science, said: “The truth is that medicine, professedly founded on observation, is as sensitive to outside influences, political, religious, philosophical, imaginative, as is the barometer to the changes of atmospheric density”. You and I have not been free from some of these influences, like any other human being. Sometimes fashions distract us and take us away from the true pathway that leads to understanding and solving the problems we have to solve. One must be very brave to be able to flee from pharmaceutical fashions, from traditionalist pressures and tenaciously to drive new ideas that go against current thinking in the field of science. Scientific progress was always dependent on the bright ideas of heterodox scientists and not on the parsimony of over-orthodox peers. Jacob Bronowski (1908-1974), the British scientist, mathematician, and writer, said: “That is the essence of science: ask an impertinent question, and you are on the way to a pertinent answer”. For John Dewey (1859-1952), US philosopher and educator, “every great advance in science has issued from a new audacity of imagination”; and T.H. Huxley (1825-1895), the British biologist, wrote that “science… commits suicide when it adopts a creed”. In our case, I think that Professor Nishimura must be happy with our work following his visionary insights into the pathological nature of dementia. We have been (and still are) honest pupils, honoring our master with a full dedication to our scientific passion. In his memory, let me refresh with you a fragment of The Hippocratic Oath, following the doctrine of our father Hippocrates (c.460 BC-357 BC): “I swear by Apollo the physician, by Asclepius, by Health, by Panacea and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture. To hold my teacher in this art equal to my own parents; to make him partner in my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers and to teach them this art, if they want to learn it, without fee or indenture; to impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the physician’s oath, but to nobody else…”
One of our commitments is to translate to our pupils the idea of prevention in medicine. One of the greatest historic failures of medicine has been our inability to design preventive strategies against the most disabling diseases. Moreover, as Henry E. Sigerist (1891-1957) said, “prevention of disease must become the goal of every physician”. Our generation has lived locked in the dogmatism of a restorative medicine based on dogmatic principles imposed by custom. Unfortunately, books do not contain all we need to know. In fact, Rhazes (865-928) said “truth in medicine is an unattainable goal, and the art as described in books is far beneath the knowledge of an experienced and thoughtful physician”. Paracelsus (1493-1541) pointed out that “medicine is not only a science; it is also an art. It does not consist of compounding pills and plasters; it deals with the very processes of life, which must be understood before they may be guided”; and ironically, but full of reason, George Bernard Shaw (1856-1950) said that “optimistic lies have such immense therapeutic value that a doctor who cannot tell them convincingly has mistaken his profession”. When we face the impossible we have to improvise compassionate formulas, but our moral obligation is to fight against the impossible and to investigate the mysteries of biology in order to be effective in the search for the best solution to save the lives of our patients.

My dear Masa, on a day like this, I bid you an affectionate farewell and welcome you to the Eden of Retirement from where I expect you to shed light on new ideas, enlightened with the flavor of wisdom. Your experience today will be mine tomorrow and I want to continue learning from you, as I did when we were young. Do not forget that self-reflection is the school of wisdom.

Yours always

Ramón Cacabelos
Professor of Genomic Medicine