Emanuel M. Papper, M.D., Ph.D.

Visit to Taiwan and Japan

By E.M. Papper, M.D. and Patricia Papper

May 16, 1985

This is the Diary and log of the trip to Taiwan and Japan begun on the 16th of May 1985. Pat and I flew nonstop from Miami to Los Angeles and checked in comfortably pretty much on time at the Westwood Marquis Hotel in Los Angeles. Deborah and Patrick joined us for a light evening supper, and we had a very pleasant and happy conversation with them. We then went to bed and did not sleep too well because of the change of time possibly and the prospect of the long flight ahead on Friday the 17th of May. On Friday morning we relaxed and took a brief walk around the hotel. The weather was very nice and we went out to the airport rather early, apparently misinformed as to departure time by the people at China Airlines. The flight took off Friday afternoon, approximately 4 PM Los Angeles time. It was a very comfortable flight from the stand point of service and all the amenities that one could want, but 13 hours and 10 minutes non-stop between Los Angeles and Taipei was a bit much and we were rather tired.

I had misinformed our Abbott host, Mr. Raymond Wong, that we would be coming in on Sunday the 19th of May. The mistake was made in miscalculating on my part the time change in crossing the International Date Line going towards the Orient. We actually did arrive, of course, on Saturday night the 18th of May, but happily for us Raymond Wong knew about the error and was there to meet us, and the Grand Hotel was informed of our coming in on Saturday Night. The ride to the Hotel from the airport was as pleasant as it could be considering our fatigue. When checking into the Hotel all was pleasant; we had a beautiful room with a good view over the river and settled in for what turned out to be over 12 hours night's sleep.

On Sunday, May 19th we were free to recuperate from the long flight, and after awakening at approximately noon Taipei time, we wandered around the town nearby and bought some minor things, like socks for walking, and explored some of the downtown area. The streets were quite interesting – many, many shops, restaurants, barber shops, and the like. We came back to dine at the hotel and were rather disappointed with our first dinner because of the presence of relatively large numbers of tour groups in the Cantonese Restaurant of the Grand Hotel. We did go to sleep early to help overcome the jet lag problem which was really not too bad.

Monday, the 20th of May

We got up relatively early and Pat called Siwa Ngai's sister, who lives in Taipei with her mother and has done so for the last five years. We've met her sister a long time back when she lived in New York. We were pleased to see her very much and to learn that she was doing architecture for the last couple of years. Their mother was not treated kindly by time and she looked quite a lot more frail than I had seen her last which was, of course, a long time ago. We did have a very pleasant lunch and a good discussion. One of their cousins was also present, visiting a father who was sick with an illness causing pyloric-duodenol obstruction from an external mass as yet unknown at the time we talked. We came back to the hotel by taxi and rested for a short time, before Raymond Wong picked us up to take us to dinner at a charming Cantonese Restaurant where the food was excellent. We had a good talk with Raymond and learned about his working for Abbott and starting a branch office in Taipei. He is originally from Hong Kong and is doing an excellent job in his work.

Tuesday, May 21, 1985

Pat changed some of her plans and instead of taking an organized tour which Siwa's sister had advised against, she spent a bit of time shopping and visited the fantastic museum which contains the great treasures which were brought over by the Nationalists when they left the Mainland of China after the Communist Revolution in 1949. Siwa's father had much to do with the establishment of this museum when he still worked for the Government.

This particular day was a long and interesting one for me. It began not too early in the morning with a visit to the National Taiwan University Hospital where I was received by Dean Yang. He had previously been the superintendent of the National Taiwan University Hospital before becoming Dean of the Faculty of Medicine and was himself a chest internist. His interest in Anesthesiology and its development were mildly appropriate, but certainly of no great interest one way or the other. This was a harbinger of news to come in general about Anesthesiology in Taiwan and specifically at that institution. After this visit I met with Dr. Chen, prior to meeting with the person I had known before in my previous visit to Taiwan, Professor Chi Ching Chao, who was the Professor of Anesthesiology for a very short time prior to having a stroke which disabled him considerably from the time of 21 years ago when I last saw him. When Professor Chi became ill the University felt that there was nobody qualified in Anesthesiology to head the Department, and a young surgeon, Professor Han, was appointed Chairman of the Department of Anesthesiology--an ample demonstration of the lack of interest or appreciation of Anesthesiology as an academic or even a clinical discipline in Taiwan. S.H. Ngai had warned me about the sorry state of academic anesthesiology in Taiwan .

From there I went to visit the President of the Republic of China Society of Anesthesiologists, Dr. Chuan-Lin Ching, who is a Colonel in the Army and is the present Chairman of the Department of Anesthesiology in the Military Service Hospital which is known as the Tri-Service Hospital. He is an intelligent person who has had some of his education in Anesthesiology at the University of Chicago (a situation that I learned was very common indeed with some of the senior people in Taiwan). His institution was more stable than the one at the National Taiwan University Hospital and consisted of a small staff, a few residents, and a relatively larger number of Nurse Anesthetists and student Nurse Anesthetists.

Following this visit there was lunch with these gentlemen and Mr. L. Kao, the sales manager of Abbott in Taiwan and one of his colleagues Mr. Sherwyn Hung. After lunch I visited a Presbyterian Voluntary Hospital, known as MacKay Memorial Hospital in memory of Dr. Gordon MacKay, a Presbyterian Medical Missionary who founded the institution nearly 100 years ago. The head of the Department, Dr. Cheng, was a very vigorous and relatively young man with a department of similar complexion and composition to that of the Tri-Service Hospital, although its clinical activities seemed to be considerably more elaborate.

After this visit and meeting and looking at their facilities, I was taken to meet Professor Tseng of Kaohsiung Medical College in the south of Taiwan to try to help him plan a visit to the United States for some six months as an observer in various of our better academic institutions. Whether this will be possible or not I do not know, but I will certainly attempt to do so because he seems deserving of help and the people of Abbott are very much-interested in furthering his career.

There was then a meeting of the Anesthesiologists of Taiwan at which I spoke on the evolution of halogenated anesthetic agents, resulting in its latest development in the clinical usage of Forane. This was a cultural and historical overview. Several questions were asked in the discussion period by some young Anesthesiologists and mostly about Forane's effects on the central nervous system. There was finally a paper presented by one of the local anesthesiologists, a pleasant young woman, who described in rather ordinary terms experience with Forane on some 233 patients. There was nothing particular that I learned, although it was an interesting kind of presentation. The oral presentation was Chinese and all the slides were English so that I could follow at least the drift of the discussion. Her main point was that Forane would be a valuable anesthetic agent if it could be used economically, and for that she recommended a low flow closed system type of technique. Others in the audience differed with this view to some extent, but the resolution of the attitudes towards low flow closed techniques I could not determine since the discussion was entirely in Chinese. Later, in attempting to assess the things, I found that some were in favor of this technique and some were not as one might have expected.

Pat was brought to the dinner which took place after the meeting, and the dinner was a buffet type of meal of medium quality at the Ambassador Hotel near the MacKay Memorial Hospital. The people were extremely pleasant and very nice in every respect. It was quite apparent from this dinner that Chinese physicians and nurses and their spouses drink very little alcohol and many are total abstainers. There seems to be a culturally determined habit of lack of interest in strong drink. I have tried to determine how accurate the observation was without too much success, except that everyone seemed to take it for granted. Also, nobody smoked at any institution that I visited or during any of the discussions we had.

Wednesday, May the 22nd

Pat did some shopping with a pleasant guide and driver provided for her by Raymond Wong, and she went to a pottery factory and enjoyed that visit and did some shopping for herself and for me. I received a very beautiful and useful purse and she bought two very pretty necklaces.

While this was going on I was visiting the Chang Gung Memorial Hospital and Peter Tan, the head of that department of Anesthesiology. This hospital was built by an entrepreneur of great wealth, and there is some difference of opinion from people I asked as to whether the Hospital was a profit center for his business enterprises or whether it was a donation for the public good. I had opinions on both sides and do not know what the truth is. Peter Tan is a very competent and intelligent person clearly able to take on any clinical activities. He is rather better known than most of the Taiwanese Anesthesiologists in Europe and the United States and travels with some frequency to both parts of the world. He had his residency in Anesthesiology at the University of Chicago at the time that Harry Lowe was the acting Chairman of that department.

From there we went to Veterans General Hospital to visit its Anesthesiology Department, and this has great interest for me from the standpoint of personal involvement. I visited the operating suite where George Humphreys and I took care of Madame Chiang Kai Shek in 1964. The Presidential Suite is still used by the Presidential Family when a member of the family requires operative surgery. Nothing, however, looked very familiar and this is not a great surprise, since our concentration was on other aspects of our work there. There was one nurse still at the hospital who was present at the time of that operation, and it reminded me of the exciting experience that we all had removing Madame's gall bladder.

I then met Pat and L.C. Kao and Raymond Wong for lunch at a Japanese Restaurant. We had a pleasant meal and Raymond than took off for Hong Kong for an Abbott meeting there. Pat and I went to the National Museum with Richard our guide, and I had a most interesting experience in seeing the marvelous collections and great treasures there. We dined in the evening with Amy and Peter Tan at a French restaurant way off the beaten track and very pretty, "Le Lune Vague" restaurant. Its chef was French and its management was Chinese. It was in a private house. The food was excellent and the decor was most interesting. It was largely a collection of relatively old pieces from Mainland China.

Thursday the 23rd of May

Pat and I were picked up by a driver and a guide in what turned out to be a sunny but very hot morning at about 9AM. We visited a temple of Confucius which evidently is not religious, but more a philosophical and contemplative experience. Confucius was the greatest of the Chinese Philosophers. His birthday, which is the 28th of September, is celebrated with great festivities every year even some 2,500 years later at the present time.

After lunch our guide and driver picked us up with Mrs. Amy Tan, the wife of one of the Senior Anesthesiologists in Taipei. We drove past the National Palace Museum to pick up one of the official guides there and to visit the home of the distinguished Chinese Artist Chang Dai-Chin, who lived in Taiwan after the Communist Revolution. As a matter of fact, he spent some twenty years or so earlier in Paris and knew Picasso and other distinguished artists. He is especially well known for his traditional Chinese paintings and seems to be one of the modern gifted artists of this generation.

May 24th 1985, Friday

We left the hotel in Taipei at 10AM with two very nice young men from Abbott, Mr. Sherwyn Hung and Mr. L.C. Kao, after we had had a splendid evening with them the night before at a Mongolian Barbecue which was really quite pleasant and interesting. Among the people that I had met during these few days was the new Professor of Anesthesiology at the National Taiwan University, Doctor Han, who actually is an expert in Sports Medicine. He seemed to be embarrassed that he was heading the Department of Anesthesiology and indicated to me that there simply were not enough senior people of competence in Anesthesiology to deal with it. The discussion revolved around some of his interesting sports patients, among whom were quite a few well known tennis players. It then turned out that in Taiwan most of the excellent tennis rackets, including the Prince, were manufactured there. It may be that we shall be receiving a new kind of racket to try after our discussion because of our interest in tennis.

We left the hotel and Taiwan in a caravan of limousines; Pat and I with the driver and the two young men with our luggage in a small car. Seems we have a bit more luggage than is easily accommodated in one car. We then went to the airport some 45 minutes drive away along pretty countryside. We flew from Taipei to Osaka on Japan Asia Airlines, a subsidiary of Japan Airlines, which carries this other name because of their flying to and from Taiwan and Hong Kong, in deference to their relations to the Peoples Republic of China . We flew through a fair bit of turbulent air because there was a typhoon off Okinawa, the southern most island belonging to Japan, and a very well known airbase from which the American Air Force attacked the Japanese towards the end of World War II. The typhoon caused not only air turbulence but a considerable amount of rain, which was present during much of our stay in Kyoto .

We landed with ease on time, however, and experienced a very high humidity environment and delays going through Immigration and Customs in Osaka. The delays were incredible and the whole operation was most inefficient, and if it weren't for the fact that it is similar in most of the ports of entry in the United States, a foreigner would have every right to be upset with Japanese ports of entry as I suppose they are with American ports of entry. After a hour or so of delay we finally emerged from Customs and happily there was Ken Mori to meet us. He had a large taxi to drive us the 50 minutes or so from Osaka Airport to our Hotel Miyako in Kyoto. It was very good to see Ken again and he looked fine and was I think quite happy to welcome us there since he was a very pleasant host.

We then bathed and cleaned up a bit prior to going to dinner at the home of the Moris. This was my first visit to a Japanese home, with or without a meal, and it was an experience that Pat and I were looking forward to. Itoko Mori is a Pediatrician and a very outgoing lovely young woman who was our hostess. We had much pleasant and interesting conversation and the usual exquisitely prepared Japanese meal where all the food looks so good and also tastes quite good. It was essentially a vegetarian meal with a little bit of other materials in the form of one piece of smoked salmon and quail egg. The presentation of food in Japan is terrific, but it is very time consuming to prepare. This the woman of the house, at least in this instance, did all by herself, but it took her an entire day of preparation.

We met their two daughters, one of whom is in the University studying Economics and the younger is going through the terrible trials of extra schooling in the hopes of being admitted to the University to study Medicine. Their examination system has been very well described by others, and Reischauer describes in his books the torments and the enormous difficulty of the entrance examination systems to the University. It is all crucial to future careers. The strange thing is, once the successful applicants are admitted to the University, it seems that their period of work and study is nearly at an end and they seem to avoid classes and "Enjoy life for the first time," since their careers seem to be assured and actual higher education is less important than being identified with being admitted to the University and graduating. The two Mori girls are age 19 and 17 and are certainly very pleasant young women. We went back to our hotel with Ken Mori driving us there and got to bed at a reasonably early hour. Our sleep rhythm is improving a good deal, and each night we seem to fall asleep more easily and to sleep a little bit longer.

Saturday, May 25th

I gave a lecture to the Department of Anesthesiology at Kyoto University and talked at Professor Mori's request on the Assessment Quality in Clinical Anesthesiology in the United States. I described the educational program approved by the American Board of Anesthesiology and discussed some of the flexibility and the methods of practical and didactic teaching within our system and also attempted to emphasize the American strength of pluralism in the variation among different departments in striving toward the same, or similar goals. I also discussed the Peer Review System and the Quality Assurance Program and how we use it in an attempt to improve the quality of Clinical Anesthesia. There were a few questions and we had a pleasant and interesting time.

While this was going on, Pat was shopping for antiques and bought a few lovely old things. She got three bronze pieces that are attractive looking and hopefully we will enjoy when we have them at home. We then met Ken Mori for lunch, which was our first western meal since we have been in the Orient. It seemed to be good to have that much of a touch of home, even though their Japanese food is really exquisite to look at and pleasant to eat.

We then went to visit the Kyoto National Museum which had many ancient objects, many of them prehistoric going far back into Japanese History. There was much Chinese influence, and Japanese culture is obviously a derived one, at least as far as art objects are concerned, but a more simple version of the Chinese ones. Their attractiveness is in their simplicity. We saw ceramics, porcelain, pottery, paintings, some bronze, stone and semi-precious jewel artifacts. After our sightseeing, we rested for a short while and then had dinner at a very elegant Japanese Restaurant with several of our old friends important in Japanese Anesthesiology. I had dined with Pat with all of these gentlemen some six years ago on our last visit to Kyoto, at that time in a French Restaurant.

None of the wives of my now old and good Japanese friends attended the dinner, nor did Itoko Mori. In fact she spent no time with Pat, unlike what would happen in the West if there were a wife of a visitor coming to either work or visit one's professional colleagues. I am unable to determine whether this is conditioned by the notion that the woman must stay at home or whether there are other factors. Dr. Itoko Mori, for instance, works in a hospital three days a week as a Pediatrician and travels occasionally with her husband. They dine out together or with friends, but somehow or other the Japanese woman does not attend these special dinners or pay any attention to hospitality to the wives of their colleagues and their husbands. It is a striking thing which will take more thinking about, because it seems to fly in the face of the very obvious consideration and concern for making a guest extremely comfortable and well cared for in Japan. Perhaps women just don't really count as yet except in the home.

Before dinner we visited the National Museum of Modern Art which was quite fascinating, in that Japanese artists of considerable talent were shown in what I take to be a permanent collection, from the earliest 20th century to the present. There was a marked degree of influence by the French Impressionists on the Japanese Painters of the same period, and yet there were clearly strongly Japanese appearing overtones to all of it. We had a reasonable night's sleep.

Sunday morning the 26th of May

We had a two hour walking trip with Ken Mori and visited an Art Gallery that had both Japanese and beautiful French Impressionistic paintings--then a visit to a Buddhist Temple and a Shinto Shrine which were pleasant, quiet and the gardens very beautiful. We left for the train station and in ample time to get aboard the Bullet Train which left for Tokyo promptly at four minutes after two. I am dictating this part of the diary while on the Bullet Train, and that is what the background noise is about. The first hour or so of the trip took us through rather densely populated rural areas, and a very large number of very small rice paddies.

The evening of Tuesday the 28th of May

We went to a Japanese Restaurant in Tokyo which specializes in Shabu-Shabu, which is essentially a water fondue type of cooking. The meal consisted of a first course of a cold lobster-like fish or raw fish. The Shabu-Shabu dish was very thinly sliced Kobe beef, which you then put into the scalding water and leave as short or as long of a time as you wish in order to have it cooked the way you like. After the beef, vegetables of various kinds were cooked in the same manner. We had a small gelatin like sweet dessert which was extremely difficult to handle with chopsticks and wasn't at all that good. The Shabu-Shabu type of cooking is one that many people seem to use in a variety of ways, and it certainly is pleasant. From dinner we walked back to the hotel and went to sleep relatively early. Dinners in Japan are always early. It is unusual to have dinner begin after seven and most commonly it begins at either six or six-thirty. I am sure that the long fancy parties for men only are explained on some other basis, but the dinner does start early with them and just lasts a longer time.

Wednesday Morning the 29th of May

We had a peculiar event. Pat and I slept very well for several hours and then our message blinker, which is difficult to avoid noticing since it's a bright red light, started to blink and this was about four-thirty in the morning. When I called to check on the message it turned out that Frances had called from Miami, and there was no way of evaluating the need to return the call promptly or not. After discussing the call with Pat a bit, we decided to return the call at once, motivated primarily I guess because the time difference from Eastern Daylight Time to Time in Tokoyo is exactly 12 hours earlier on the East Coast of the United States of the preceding day, we would expect to find her in the office. A dial call went directly through without problem and I spoke to both Terri and Frances and all was well in Miami. The question she had called about was the Audio-Digest permission to tape my lecture at the California Society of Anesthesiologist which, of course, was O.K. to do. We then fell asleep for another two hours and a half or so and awakened, had breakfast and found a slow drizzling rain in Tokyo, which is not altogether pleasant in that city.

We left for the Airport quite early expecting a difficult traffic situation, and for the first time there was no traffic problem. We flew easily to Akita with our Tokyo "responsible persons", Professor and Mrs. K. Fukushima and Hideo Nakishima, Francis Foldes' protege in New York. The flight on all Nippon Airways, which is a private carrier, was on a Lockhead 1011 and was completely full -- all tourist class. It seems that all of Japanese Anesthesiology will be present in Akita for the National Meeting, and it's almost as though Surgical Death takes a Holiday with no Surgery except Emergencies being performed anywhere in this country!

We arrived in Akita in a sunny environment and saw the many rice paddies in valleys between mountains. This is an important rice growing and fishing area of Japan and it certainly looked it. We were taken to the Akita View Hotel by the Abbott people, and it makes all the difference to be so comfortable thanks to their efforts. The hotel is a pleasant one in a small town and was a refreshingly better one than we had expected it to be. We took a walk to see the outdoor nurseries, which are rather striking at this time of year, and watched some experienced gardeners preparing pine trees for Bonsai shape for the future. They also did some interesting topiary work on other pine trees. The Japanese are simply fabulous with plants and flowers.

We then went to a museum, small in size, at the top of the hill past where the nursery market was to see the paintings of an artist whose name I can neither spell nor pronounce, and they were only of medium interest. We walked back through the town and got some feel of it, and everywhere there were pleasant, cooperative and very friendly people, as we had been experiencing all through Japan. We went to one antique shop which had some paintings and other antiques. We returned to the hotel, changed clothes, and went to the Headquarters Hotel (Castle Plaza Hotel) for a French meal which was very large in volume for French food and of medium to average quality, but a refreshing change from all the Japanese food we had been eating. The weather turned considerably cooler in the evening, and we went back to the hotel where I have been dictating this piece ending the 29th of May.

Thursday, the 30th of May 1985

After a pleasant light breakfast in our room, Pat and I went to the Congress Hall where we met the President of the Japan Society of Anesthesiologists, who is the host for this meeting. It is their custom that the Annual meeting is held in the home city of the President. He is Professor Watabe, who is a good friend of Ole Secher and actually learned his Anesthesia in the World Health Organization course in Copenhagen about 1960. We also were very happy indeed to see Nick Greene from Yale, who is an old and good friend, and later met his wife Jean at lunch. Nick had spent a week or so in Hokkaido in the North of Japan bird watching, which is an important hobby to him. We also met David and Mary Lou Steward. Dr. Steward was formerly the head of the Clinical Service at the Hospital for Sick Children in Toronto and had been there for some fifteen years or so before moving last November to the Children's Hospital in Vancouver at the University of British Columbia . He is one of the experts on the care of premature infants from an Anesthetic and Intensive Care standpoint. He and Greene gave their lectures today, and I am scheduled to speak on Friday the 31st of May at the Plenary Session. All of us had lunch together, except those who were speaking at the meeting, at the coffee shop of the Hotel Akita View.

After lunch we went to the Foujita Museum (which has another name) but has evidently the largest and best collection of Foujita paintings in Japan and possibly in the World. Foujita was an accomplished Japanese artist, strongly influenced by the French Impressionists, and spent much of his life living in Paris. It was a great delight to see this collection, which is owned by the local province of Akita. It also has a large number of Goya etchings and a few other French Masters, as well as some other Europeans, but the prize of the collection is the Foujita Collection. There is an enormous mural done in oil as well as a large number, perhaps close to 300, (so we were told) of paintings in the museum, not all of which were on exhibition. After lunch we strolled through some of the town and looked at a few antiques shops and were lucky enough to find some woodblock prints of an artist who is a local to Akita and whose paintings are shown in a small museum here. They are exquisite and will look beautiful in Miami.

After the purchases we made of the woodblock prints, we returned to the hotel and Pat and I took a brisk two mile (approximate) walk on a jogging track that is on the roof of the hotel. I think this was good for us and other than walking as tourists from place to place this was the first real exercise we've had in some two weeks.

The evening was a Japanese meal at an elegant Japanese restaurant with the power structure of my generation in Japan, i.e. Professors Yamamura, Amano, and Inamoto, as well as the director of Abbott affairs in Japan, an Englishman named Michael Bassett. He is a very pleasant and interesting person and the social occasion was a happy success, but I must confess we are getting a bit weary of overeating or being at least exposed to too many courses of Japanese food. It has only so much mileage in it!

The first of June, Saturday

Tom Oyama, who had been our host during a previous Japanese visit at Hirosaki where I first met Horst Stoeckel at another National Japanese Meeting, took us with car, guide and driver to a spa at a place called Hannamaki. This lovely town is midway between Akita (which is about an hour by air from Siberia) to a town in the Northeast of Japan called Sendai. We spent the night at a Riyakon (Japanese Hotel) and enjoyed all the personable and lovely amenities of that kind of existence. We also took the waters and the baths and had a very happy and relaxed time. We had driven before arriving in Hannamaki to see some of the older parts of Japan, and a small number of older buildings which go back to the Pre-Meiji Restoration. So much of Japanese housing, including the dwellings of the Nobility and the Imperial Family as well as the Shogun's Family, were built of wood and paper products that they, in many cases, were burned to the ground and restored at the time or rebuilt. I think this constant harassment of nature to Japanese housing has made the modern Japanese relatively less interested in preserving their palaces and houses in the same way that the Europeans did at roughly the same period. Their preservation in Japan seems to be mostly artifacts and certain kinds of floral effects. When we left Hannamaki for the Bullet Train to take us to Sendai, we were in for a very pleasant experience.

One of the able research neurologists in Miami for some 15 years was a Japanese who had responded to the patriotic call to return to Japan and assume the Chair in Neurology at that Institution. He was an old and dear friend of Bob Daroff's whom we had met by chance in the Hotel lobby in Kyoto some days earlier, as well as having met George Dooley the President of Channel 2 who was in Japan on business related to the Public Broadcasting System. It seems as though we always meet somebody we both like and cherish in these various trips. We spent a delightful time with our Japanese colleague and his Anesthesiology counterpart, Professor Amaha, who had his anesthesia training at Duke University with Merel Harmel. It was altogether enchanting. The meeting with Bob and Jane Daroff and the wonderful meal we had in Japan in Sendai were a fitting end to our trip there.

When we left Sendai it was by car to go to Narita, Tokyo 's airport. The Abbott people helped us with this transfer, which was of invaluable assistance. We flew to San Francisco from Tokyo and regained the day we had lost previously. We were whisked quickly through San Francisco Customs and in fact were in bed at the Stanford Court Hotel within an hour and a quarter after landing in San Francisco to have a much needed even though short sleep. We dined that evening with Paul and Linda White. He is a very able young Anesthesiologist at Stanford whom I like a great deal, and his wife is an equally charming person. Our dinner was our first real Western one in a charming French Restaurant in San Francisco.

June the 6th, 1985

The next morning, I spoke before the California Society of Anesthesiologists and gave the Leffingwell Lecture there. It seemed to me that the lecture was quite well received. That evening we had an absolutely marvelous dinner and happy reunion with Sol Shnider and a few of his friends. His apartment is completely charming and shows all the marks of Sol's great aesthetic taste in so many respects. It was a warm and very happy reunion and did lead as things turned out to his being willing to come to Aspen for the 70th Birthday Party. We returned home the following day after a most interesting working trip to Taiwan, Japan, and San Francisco .

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