Dr. Tadataka “Tachi” Yamada (Figure 1) joins us for our next Conversation with Giants in Medicine. Born in Japan and trained in the United States as a gastroenterologist, he quickly rose to be the chairman of the Department of Internal Medicine at University of Michigan. He moved to industry and eventually became the Chairman of Research and Development for GlaxoSmithKline. In the next step in his interesting career, he took on the presidency of the Bill and Melinda Gates Foundation Global Health Program. In this capacity, he oversaw over $9,000,000,000 in programs directed at addressing health challenges of the developing world. In 2011, Dr. Yamada moved on to become the Chief Medical and Scientific Officer (CMSO) and Executive Vice President of Takeda Pharmaceuticals. The full interview can be seen on the JCI website, http://www. jci. org/kiosk/cgm. JCI: Can you tell us a little bit about your path to get to medical school? Yamada: Well, my grandfather was a physician. He died before I was born, but my mother would often talk about him and talk about the profession as a very special profession. So, I grew up wanting to be a physician. For my third birthday I asked for a stethoscope and I got one, so I played doctor. But at one point in college, I got more interested in history and philosophy and I was actually scheduled to go to graduate school with the Woodrow Wilson Fellowship, but it was the time of the Vietnam War, so if you went to medical school, you were deferred from military service. JCI: Did you do any scientific research during medical school? Yamada: Because I was a history major in college, I was not trained in science like many other medical students were when I went to medical school. When I got to medical school and the first few years were all about science, I was way behind. I really didn’t understand it, know about it, or care about it. But it was really when I went on the ward services as a third-year clerk that I realized you had to be a good scientist if you were going to be a good doctor. And that’s what transformed my interest in medicine and in research and science. In my fourth year in medical school, I actually spent a good part of my elective time working in the laboratory of a pulmonary physician at NYU named Roberta Goldring.

JCI: Your early start was in the pulmonary field, but you made your mark scientifically within gastroenterology. Yamada: The Medical College of Virginia, where I did my residency, had a strong GI division, and they got me very excited about gastroenterology. In the meantime, I had to take a detour into the military, because I was a Berry Plan Officer. I spent three years at the US Army Medical Research Institute of Infectious Diseases in Fort Detrick, Maryland. I did research there—they gave me a lab and a technician and some money and said,“Do research.” I wasn’t quite sure how to do it, but I spent time at the NIH and learned some protein chemistry. I was trying to understand the role of the bradykinin system in septic shock, and that got me interested in small peptide molecules. Amazingly enough, because the military set you up this way, you either became a very independent investigator right away or you just didn’t become an investigator at all. By the time I finished my army commitment, I had seven papers, but I didn’t have a mentor, I hadn’t worked in anybody’s lab; I just had to create my own lab and do research. JCI: What was your path from there to the University of Michigan? Yamada: I went to UCLA for my gastroenterology fellowship. One of the fathers of modern gastroenterology, Morton Grossman, was there, and I wanted to train with him, and he was interested in peptide hormones that altered …