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Bridging Cultures in Medicine:
A Fulbright Journey Through Japan’s Public Health Landscape

Arthur Bookstein, MPH

I first met Arthur Bookstein in January 2025 at Japan’s National Cancer Center (NCC) while giving a talk on Gastric Cancer in the U.S. As a Fulbright scholar and medical student from USC, Arthur stood out not just for his keen interest in cancer epidemiology but also for his deep curiosity about the intersection of medicine, culture, and public health. Our conversation quickly turned into a discussion about global health disparities, early detection strategies, and the importance of cross-border collaborations in medicine. His passion for research and advocacy was evident, and it was clear that his time in Japan was shaping his perspectives in ways that extended beyond the lab. In this article, Arthur shares his unique journey in Japan-exploring the country’s approach to cancer prevention, immersing himself in the culture, and reflecting on how these experiences will shape his future in medicine and public health.

Chul S. Hyun

Hi there! I’m Arthur, a fourth-year medical student at the Keck School of Medicine of USC with plans to pursue a combined Medicine-Pediatrics residency and a Hematology/Oncology fellowship. I studied molecular biology and public health at UC Berkeley, where I also earned my MPH. During these years, I became increasingly interested in global health and epidemiological research as avenues to extend the impact of my work to larger populations and address health disparities on a larger scale. This eventually led to my partner suggesting that I apply for a Fulbright research grant to Japan, which would give me the opportunity to get further in touch with my Japanese heritage while working with internationally renowned cancer researchers. I initially thought the idea sounded neat but didn’t think I had a realistic chance of winning the award. Still, when it came time to apply, I decided to give it a shot. I began preparing my application towards the end of 2022, with no idea that almost two full years later, I would be flying to Japan to begin my year as a Fulbrighter.

Japan has one of the highest burdens of HCV-related liver cancer in the world, making it crucial to examine how social risk factors shape disease outcomes. The rapid westernization of the Japanese diet-marked by increased consumption of processed foods and red meat-alongside historically high smoking rates and a deeply ingrained drinking culture, has further influenced liver cancer trends. These lifestyle shifts, coupled with an aging population, have led to evolving disease patterns that challenge existing public health strategies. Addressing these dynamics requires nuanced, data-driven approaches, which is where my Fulbright project comes in. At the National Cancer Center of Japan (located in Ginza, Tokyo), I am working with researchers to investigate how diet and other social determinants impact the progression of viral hepatitis to hepatocellular carcinoma (HCC). My research involves analyzing large epidemiological datasets, refining statistical models, and iteratively improving data organization to enhance predictive accuracy. Ultimately, my goal is to better understand how simple interventions (such as increasing one’s fruit and vegetable intake) could reduce HCC risk, which can then inform the design of targeted prevention strategies.

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Though I’ve visited Japan many times before to see family and travel, working here has been an entirely different experience. The transition into Japan’s work culture took some adjustment-precision, thoroughness, and consensus-driven decision- making are deeply ingrained in the research environment. At times, this approach means that projects progress more slowly than I’m used to in the U.S., but I’ve come to appreciate the emphasis on detail and the collective commitment to getting things right. This environment has sharpened my analytical skills, strengthened my ability to work within a team, and given me a new perspective on work ethic. Japanese work culture has a reputation for being intense, but I think there are aspects the U.S. could learn from-particularly the department-wide group workout in the middle of the day, which seems like an obvious win for productivity and well-being.

Outside of work, I’ve been trying to make the most of my time off to explore the country and the culture, and maybe learn a thing or two about myself along the way. Biking around Tokyo, weaving through narrow alleyways, bustling streets, beautiful parks and tucked-away temples. Watching the sun set over the endless Tokyo skyline. Attending lectures at the University of Tokyo and conferences in south Shikoku. Inhaling delicious Japanese cuisine at every opportunity (despite the variety of incredible dishes to choose from, I always find myself coming back to a simple bowl of kitsune udon as my proven favorite). Experiencing hanami (cherry blossom viewing) in Yoyogi Park. Destroying my legs running marathons along the Tosa bay and at the base of Mount Fuji. Visiting Hiroshima and reflecting on the immense effort and sacrifice required to build and maintain peace. My most adventurous excursion was over the New Year’s holiday, when I went on a biking trip through Kansai, circling the stunning Lake Biwa and making my way through Kyoto, Uji, Nara, and Osaka before returning to Kyoto. I wandered through Kyoto’s ancient temples, sipped artisan matcha tea in Uji, made friends with the deer in Nara, and took in the bright neon streets of Osaka at night.

More than anything, this year has been a time of personal growth. I’ve studied Buddhism and Stoicism, meditated with monks at the mountain temple Enryakuji, and worked on cultivating a deeper appreciation for the people and world around me. I’ve learned to be more observant, to notice the small things, and to gradually find inner peace. My time in Japan has also helped me understand the cultural context behind Japanese social norms- why the collective and social order are prioritized so much, and how this has historically helped the nation persevere through natural disasters and other challenges. While rugged individualism and openly expressing emotions may work well for Western societies, that doesn’t necessarily mean it’s the best approach for Japan. This realization has reinforced the broader idea that there is rarely a one-size-fits- all solution to any problem, no matter how universally sound it may seem-context always matters.

Experiences like my Fulbright year are invaluable for personal and professional growth. Stepping outside of my comfort zone, deeply understanding different perspectives, and engaging in self-reflection have all shaped my worldview dramatically. This kind of cross- cultural exchange is especially important today, at a time when people are increasingly divided and often unwilling to understand perspectives different from their own.

As I move forward in my career, I’ll carry these insights with me-the emphasis on prevention, the importance of cultural humility, and the power of global collaboration in advancing health equity. I’m incredibly grateful for this experience and excited to apply what I’ve learned to my future work in medicine and public health.

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Arthur Bookstein, MPH

MD Candidate, Class of 2026
Keck School of Medicine of USC

Arthur Bookstein, MPH is a medical student at the Keck School of Medicine of the University of Southern California (USC) and a recipient of the 2024-2025 Fulbright Research Award to Japan. He completed both his undergraduate and Master of Public Health degrees at the University of California, Berkeley, earning B.A. degrees in Molecular & Cell Biology and Public Health, with minors in Bioengineering and Conservation & Resource Studies, and an MPH with an emphasis in Biostatistics and Epidemiology.. He plans to pursue residency training in Medicine-Pediatrics followed by a Hematology/Oncology fellowship, with the ultimate goal of advocating for vulnerable populations through clinical practice, research and policy. He is the co-founder and COO of the environmental health non-profit ARCH Collaborative and an ambassador for the NIH-funded All of Us Research Program. His research interests include cancer health disparities and prevention, global oncology and Adolescent & Young Adult (AYA) cancer survivorship. He has led and contributed to research published in JNCI, CEBP, ASCO, Frontiers in Public Health, and the World Cancer Congress. In his free time, he enjoys long-distance cycling, language learning, and volunteering.