Dr. Kenji Saito, a young physician directing The Aroostook Medical Center’s occupational health and wellness service, sees big problems confronting the region’s health.
Obesity and diabetes “are just the tip of the iceberg,” said Saito, a Philadelphia native who joined TAMC last summer.
An estimated 30 percent of Aroostook County residents are obese and 14 percent of adults are thought to be diabetic — raising their risk of cardiovascular disease and threatening their long-term quality of life.
On top of that, American medicine in general remains bureaucratic, fragmented and expensive. Physicians and nurses are stretched thin and patients are left navigating a maze of insurance coverage, mixed messages, and testing and treatment options.
“We need to do something about our health care system overall,” Saito told a group of University of Maine Presque Isle faculty and students at a science seminar in February, arguing that the system needs to “give the power back to doctors, nurses and other health care providers.”
On that front, Saito and his colleagues are collaborating with others in the Eastern Maine Health System, TAMC’s parent organization, and trying to apply an approach known as “population health” that focuses on offering prevention and early interventions — for instance, helping people reverse or control diabetes before they become insulin-dependent or suffer heart attacks or strokes.
Besides factors such as the availability of junk food and sedentary lifestyles that figure heavily in the rise of diabetes and obesity, a major challenge for doctors and health workers is helping patients actually understand the basic science of their condition and their options.
“It’s hard sometimes to talk about a complex disease like diabetes,” Saito said. After encountering confusion with diabetes among some truck drivers he’s counseled, Saito started using pictograms, with words and pictures to illustrate the processes, and has enlisted coworkers and their family members in gauging their effectiveness.
In this area of public health, Saito told UMPI’s biology and science students that they have a lot of career options, as doctors, nurse practitioners, community educators or researchers. “We need more people who are not doctors who can communicate better,” he said.
Saito came to Aroostook County after spending most of his life in Philadelphia and some time in Paris, where he picked up some French. His mom Madame came to Philadelphia in the early 1970s to open her first restaurant — which women weren’t allowed to do in Japan at the time — and went on to spread her country’s cuisine and culture, as Philly’s “queen of sushi.”
He started college at the University of Pennsylvania in Philadelphia not unlike other young people: “I didn’t know what I wanted to do.” After taking science classes geared towards pre-med students and philosophy classes, he discovered the emerging field of bioethics, a multidisciplinary approach to studying health, medicine and technology.
Bioethics is “both a term and a concept,” Saito said. “The term is relatively new but the concept is centuries old. The first principle of medicine is to do no harm. But as medical technology evolves, there’s a lot of research and advances, and the rules of the game change. It helps balance complex issues.”
Saito ended up getting a combined medical and law degree and trained in preventive and occupational medicine at the Veteran’s Affairs Medical Center in Philadelphia, where he also interned with occupational health and environmental protection agencies and advised research at the pharmaceutical company GlaxoSmithKline.
As medicine evolves to serve an older, sicker population, Saito said that the principles of bioethics can be useful for analyzing the risks and benefits of different medicines or public health initiatives, or in holding institutions like hospitals and health insurers accountable.
In the past, he said, the ethics of medicine have gone either way in different situations — such as the Japanese-led human experiments on Chinese civilians during World War II, known as Unit 731.
While all the data from Nazi Germany’s human experiments were destroyed by the U.S., the data from Unit 731 were studied by American and European scientists and contributed to figuring out “how the human heart works, how the digestive system work and how the immune system works,” Saito said.
Until recently, Unit 731 was never really openly acknowledged in Japanese society, but it has been subject to more conversation and reflection, after Saito helped start the the country’s first bioethics center in the early 2000s.
It’s good to ask and wonder, he said: “Where am I, what have I done, and has everything been defensible? How do these coincide or conflict with others? This is why I’m always a fan of arguments and debates, especially in a civilized manner. You’ll learn a lot from someone who has a different viewpoint.”
