Finding My Place in the OR: A Cardiac Surgery Exchange in Tokyo

June 28, 2025

How an international observership—arranged by Operation Heart—shaped a student’s medical journey and deepened his belief in a more inclusive future for cardiac surgery.

Reflections from a Black medical student on cardiac surgery, cultural exchange, and the power of mentorship.

This summer, I had the incredible opportunity to travel to Tokyo, Japan, for an observership organized by Dr. Bobby Yanagawa as part of Operation Heart’s international exchange program. It was a rare and deeply meaningful experience—one that combined high-level surgical exposure with unforgettable cultural encounters.

Observing World-Class Cardiac Surgery in Tokyo

On my second day in Tokyo, I visited the NewHeart Watanabe Institute and was welcomed by Dr. Toshiya Ohtsuka. After a brief tour, he graciously invited me into the OR to observe a case involving the Wolf-Ohtsuka Procedure (WOP)—a combined treatment for atrial fibrillation that includes epicardial ablations and left atrial appendage resection.

The case was particularly interesting due to complications introduced by the patient’s pre-existing bronchiectasis. These complexities created a perfect learning environment, especially in understanding why WOP was chosen over standard interventions like the Watchman device. Given the patient’s contraindications for blood thinners, WOP provided a safer, more comprehensive solution.

Throughout the surgery, Dr. Ohtsuka explained his decision-making process in meticulous detail and even encouraged me to write a case study on the patient. He generously provided access to pre-op data, imaging, and history—something that speaks volumes about the mentorship culture I experienced in Japan.

A Second Observership—and the Same Generosity

The following day, I had the chance to observe a second surgery—this time at the Tokyo Bay Urayasu Ichikawa Medical Center with Dr. Joji Ito and his team. I was given a thorough tour of their cardiac ward and introduced to numerous staff members before being invited to scrub in on an aortic valve replacement with left atrial appendectomy.

Despite language and cultural differences, the surgical team ensured I felt fully supported and engaged. Every step of the procedure was explained with care and patience, reaffirming the sense of inclusion and mentorship that marked this entire journey.

Why This Experience Mattered So Deeply

As a Black medical student, entering the field of cardiac surgery can feel like stepping into a space that wasn’t built with you in mind. There are barriers—some obvious, others subtle—related to representation, opportunity, and access.

But in Tokyo, halfway across the world, I felt like I belonged.

I wasn’t just tolerated—I was welcomed. Supported. Encouraged. That kind of environment is rare, and it’s life-changing. It reminded me that while the path to becoming a cardiac surgeon isn’t easy, there is a global network of people who believe in widening that path. And many of them, like Dr. Yanagawa, are doing the work to make it happen.

Beyond the OR: Experiencing Japanese Culture

Outside the hospital, I had the chance to experience Japan’s rich cultural landscape. I attended concerts at Suntory Hall and the Oscar Peterson Theatre at the Canadian Embassy. I was especially moved by an intimate folk music performance by Manami Kakudo in a 100-year-old traditional home-turned-concert venue.

In Osaka, I visited Expo 2025 and saw the world’s largest freestanding wooden structure—a remarkable example of Japanese craftsmanship that mirrored the precision and artistry I saw in the OR.

Looking Ahead

This experience has left a lasting mark on my medical journey. It deepened my passion for cardiac surgery and strengthened my belief that inclusive mentorship and international collaboration can change lives.

I’ll always be grateful for Operation Heart, Dr. Yanagawa, and the many mentors who welcomed me so generously in Japan. I look forward to the day I can do the same for students who come after me.

—
Michael Zarathus-Cook
MD Program (Class of 2028), University of Toronto
MHSc, BSc