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Notes -
What do they offer that made this arrangement seem like a good deal to you? If I understood your situation correctly, you are an anglophone foreigner with a tenured teaching position at a Japanese research/teaching hospital, and the mental flexibility to be undertaking real steps to culturally assimilate. I'm far removed from medicine, but based on my vague understanding of academic salaries and conditions across the world I would have pegged Japan as an unfortunate example where simultaneously the standards of medical research are among the highest in the world and academic salaries and non-monetary perks are unusually low for a country at that level of development; and on top of that, the commute you described? It's hard for me to imagine how there is no employer, country or even field that could offer you a better life.
Hmm. That's a good question. I suppose autonomy, a generous research budget including travel to international conferences, and some degree of clout. I have sons of an age where my pulling up stakes for an unknown would be irresponsible. We built a house. We have a community we like in a good location and I don't want us to move.
If I were still single, and had no kids, I might make a lot of different decisions. I've never been particularly cutthroat or ambitious beyond providing a reasonably comfortable standard of living for my wife and children. And oddly the commute for me is a very Zen experience, to use that term inaccurately and shallowly. I mean to say that it is meditative for me, and because left to my own devices I am very much a homebody, it thrusts me out into the world. Kind of like how my whole life I was profoundly shy, and chose a career where I have to lecture to 120 students in two languages. It's good for me. Well, probably. Keeps me from being too comfortable.
If this isn't a satisfactory answer, well, I am still thinking about your question.
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