Dr. Takashi Okamoto, 33, is an internist conducting research at the National Institutes of Health on why the AIDS virus is so lethal. He holds the Japanese equivalent of an American MD and PhD and specializes in rheumatology, hematology and infectious diseases. He lives in Rockville with his wife and two sons.

I was born in the Aichi Prefecture . . . between Tokyo and Osaka. I entered the medical school in Tokyo that is called Keio University. I graduated in 1977, and then I joined my professor. His speciality is rheumatology, and I [began] my research career with him.

When I was there, I was doing a medical practice from 9 o'clock in the morning until 6 o'clock in the evening. We have patients in the ward, hospitalized patients and sometimes the outpatient clinics.

After that, we studied research until midnight. Of course, we had some supper, then we started the research for five or six hours. Sometimes you can't sleep because of the research.

We were looking at the antibodies in patients with connective tissue diseases. At the time, lupus [systemic lupus erythematosis] was suspected to be [caused] by a kind of virus . . . We thought lupus might be caused by one of those retroviruses.

We didn't find it.

When I graduated from medical school and I joined the lab of my professor, we talked a lot about what I should do. At that moment, I was interested in retroviruses, virology, clinical immunology. No substantial therapeutics have been evolved for viruses. We could control bacteria, mostly, and we could probably control fungus, but we can't control virus infection at all. Lots of diseases which do not have any identified causes are suspected to be caused by viruses. So I thought that virus research, especially in the clinical field, might be the most important field in 10 or 20 years. And this is exactly true.

I wasn't interested in making money, frankly speaking. Sometimes I feel like I am missing to see the patients. Sometimes I dream of seeing patients, talking to the patients who have problems with knee joints or something. [But] I was more interested in medical research. So little is known about clinical entities . . . Lots of doctors diagnose people with connective tissue diseases just by applying the so-called criteria. That kind of [diagnosis] did not seem to me to be a scientific process of decision making.

That [approach to diagnosis] is important, I know, but to understand the cause and effect relationship, we have to do some more research and get into the molecules into the cells of the patient's body.

It [research] is very fun. Sometimes it is frustrating because of the failure of my experiments and sometimes the extreme competition with others.

It is good to have competitors. If you are the only guy who is working on certain points, you can't be true and you can't be honest. If you have an idea and nobody really understands the significance, and if you have a competitor, you could discuss [it] with him.

It is so competitive, we have to be careful about it . . . You have to keep [some ideas] to yourself.

If you are a clinician and you want to be a good clinician, sometimes you have to look at the basic science. I think it is important for the doctor to do some basic research at a certain time of his life.