International Cooperative Education

ICE Alumnus Statement
Danielle Williams

Grandsoul Nara
President Takuo Tsujimura owns the hospital across the street from his original creation of Grandsoul Nara. The patient capacity or number of beds in the hospital is 68. In contrast, the patient capacity at Grandsoul is 19 and for good reason: more staff and doctors per patient. Three years ago, before the idea of Grandsoul was even brainstormed, President Tsujimura and his eldest son "Doctor" Takahiro Tsujimura traveled in parts of America to "tour" several retirement homes. Unlike Japan, he said, American retirement homes did not smell, and they had some of the latest technology. As a result of their visit, the concept of Grandsoul was created in order to accomplish three goals: use the latest medical technology, emphasize cleanliness ("no smelliness"), and allow for multiple diagnoses. President Tsujimura and his son believe the Japanese way of thinking is slow, stubborn to change, and tends to regard a system of "sameness" as a good goal. Thus, the existing Japanese health care system does not rely enough upon looking toward the future to improve, evolve, and provide better care for its people. Upon this foundation of ethics and comparative observation, I entered as an intern at Grandsoul Nara. President Tsujimura and I once discussed the "tools" each person is born with, and how people have only to realize that they have these "tools" in order to truly be useful, happy, and giving towards others in this life. In the realm of medicine, "live life to its fullest" is what we concluded from the conversation, even if it meant disobeying or at least modifying the medical advice patients receive from their doctors. For example, if you let the diagnosis of an illness or condition control you, there is an obvious imbalance. One’s attitude plays a large part in how well—or if—you recover. Even with a terminal illness, one can "die with dignity," or die knowing they lived well, as long as they didn’t completely give up their free will, their principles, or the many things they love about the life they have lived. Following doctors’ orders can be important, but one must also continue to use their "tools" in life.

During another brief meeting with President Tsujimura, he explained some of the suffering that Japan’s health care system has been dealing with over the last several decades. Grandsoul is one attempt to try and reduce the tremendous health care debt through the implementation of a new system. President Tsujimura has created a system or network of clinics connected by many "owners," be they standard patients or entire companies who are investing in Grandsoul. By the time I had completed my internship, President Tsujimura was already in the process of working with accountants to open up a new facility to the market by 2004 or 2005. The president had found a way to fund the system through stocks, government subsidies and the like, paving the way for Japanese citizens to become "owners" of a system that may provide better care than in the past. I am proud of the fact that I have been a founding member of an improved health care system in Japan through my internship with ICE and Grandsoul Nara. Some of my main tasks at Grandsoul Nara included learning the customs of preparing and presenting tea and coffee to clients and guests, translating health questionnaires from Japanese into English, role playing with staff in English, promoting and marketing the health care system to foreigners and expatriates in Japan, and generally absorbing the culture of Japan on site and off – particularly on the weekends.

During a ride in the car with President Tsujimura, I once questioned what he viewed as gender differences in the Japanese workplace. Although he admitted that the Japanese think women are much more enthusiastic about whatever they do, he claimed that men were better built for the work environment. Even though I was a little taken aback—though not surprised—by his statement, I still believe the divisions and different treatment of males versus females at Grandsoul were not as harsh as I would expect from more traditional businesses and corporations in Japan.

Perhaps one of my most important roles while engaged in the ICE program was my language learning experience. At Grandsoul Nara I took the initiative to keep daily notes of the words, phrases and customs I was learning. At the end of each day I would reflect on what I had learned by writing it in more detail in a journal or on flashcards, and I resolved any road blocks to my learning by utilizing the language textbooks I had brought from home. My language improved by leaps and bounds because of the extra effort I made to build on my incredible ICE experience. In addition, I delved into the dialect of the area I lived in, both in formal conversations and more colloquial ones with staff and friends. This made my experience even more profitable and dynamic. At the end of my internship, I was confidently speaking up in conversations and testing my skills, knowing my hosts were going to help guide me along the way. In terms of my actual role as an intern, more than a few times I tried to express my concern that I was being paid to do relatively little substantive work during my internship. But President Tsujimura merely said, "Just relax and enjoy yourself. At the beginning, you told me that you wanted to learn more about Japanese culture and im-prove your language skills while you are here, so just have fun. It is good enough for the staff to get used to you and use their English around you." Thus, I concluded that my role was to observe the structure, processes, and cultural connotations during my stay at Grandsoul. So I immersed myself in their lives, requesting any assignment they were willing—or allowed—to give me. That is, the hierarchy of the clinic was such that only a select few could give me a task to accomplish without being reprimanded for being out of the rank of their job title. That was one limit to my potential duties at Grandsoul. The other limit was the inherent restrictions about changing the status quo. Any new—if meager—ideas I tried to introduce to the staff was usually out of the norm of the clinic, and often the staff was not very accepting of change. This, I learned, was all a part of learning the culture, so I adapted to the environment and was able to decipher subtle cues about how office interaction progressed. During my last wonderful dinner with the entire Tsujimura family, I received a good deal of positive feedback about my two-month presence at Grandsoul Nara. Overall, I believe I did my best to be a part of every aspect of the Grandsoul family. Any intern participating in the ICE program should consider opening themselves up to their hosts in much the same way. After all, even though we each have differences and they appear every day, especially in a foreign culture, it is through these differences that we gain a better understanding of the myriad ways people behave and interact around the world, as well as how they view themselves through our eyes.

My Experience and Current Employment
My experience with the Japanese language, office culture and travel during my internship at Grandsoul Nara Health Clinic (Japan) in the summer of 2001 has helped me succeed in my first "real" job in Washington, D.C. with the Sasakawa Peace Foundation USA. I am currently the Office Manager and Program Assistant for this small non-profit foundation focused on US-Asia relations. If I had not delved into the experience of working in a Japanese office environment, I don’t think I would have been as prepared for the hard work of communicating in my current job.

Though I am working in America, there are definitely remnants of the Japanese work ethic employed in my office, thus my normal methods of communication have had to adapt to Japanese clients and even my boss. I have no doubt this adaptation has been made much easier due to my time at Grandsoul Nara.

I have been at my current job since May of 2003 and I am responsible for the day-to-day accounting needs of the office, as well being a key proofreader and editor of our Asian Voices seminar transcripts. Our seminars host speakers from across Asia and the United States to discuss regional and US-East Asian issues in the realm of international relations, security and economics. We also serve as one of the largest libraries in the D.C. metropolitan area catering to Japanese patrons and anyone else interested in Japan’s culture and language. But my continued passion for the language and culture hasn’t stopped in the office. My experience in Japan gave me the skills and credentials to be selected as one of six Goodwill Ambassadors for The National Cherry Blossom Festival in the spring of 2004 (www.nationalcherryblossomfestival.org), which celebrates the gift of trees from Japan to the US in 1912, and represents our continued friendship.

Overall, my internship through ICE Menlo between my Junior and Senior years as a University of California at Santa Barbara student allowed me to better understand myself through the eyes of another culture, and gave me a greater focus on my future career opportunities.