New York chef Wayne Nish shapes chopped lamb and tuna into two tiny mountains and places them on a square white plate.  He then drops a little caviar between them, like a waterfall flowing between the two peaks.  Little else is on the plate.  "A customer might not realize that the idea for this presentation comes from Japanese cuisine," Nish says, "but the influence is great."

  The same could be said of the New York restaurant scene.  Over the past ten years, Japanese cuisine has spread beyond Manhattan sushi bars and into ordinary restaurants, where the chefs are blond and the menus are in English.  Kitchens are likely to begin a meal with edamame in place of dinner rolls, serve fish raw rather than deep-fried and use soba instead of pasta.

  Sometimes the Japanese influence is as subtle as a drop of ponzu added to a dressing; at other times it's much less subtle, such as mashed potatoes creamed with wasabi.  So many of the finest New York chefs work Japanese ingredients or techniques into their cooking that Ruth Reichl, editor of a famous food magazine, says: "I would say there are none that don't."　　　　　　

 Surely the greatest effect Japanese food has had on American cuisine is to cut the need for fat as a taste booster.  So it's ironic that the Japanese influence came to the U.S. by way of France, home of butter and foie gras.

  It all began around the '60s, when Japanese students at the great French cooking schools gave away their own trade secrets.  Soon Parisian chefs started to use such Japanese techniques as arranging food beautifully in tiny amounts.  "The simplicity and sophistication of Japanese food presentation impressed chefs in three-star restaurants, and this had a great influence on nouvelle cuisine," says Jacques Pepin, French chef and TV host.  "The Japanese influence was, I believe, far greater than that of Chinese cuisine."

  Americans were slower to accept Japanese cuisine.  But when nouvelle cuisine swept American cities, it carried along its strong Japanese element.  When raw fish first appeared on West Coast plates, "people were really shocked," says Leslie Brenner, author of American Appetites.  "Americans didn't eat tuna except out of a can before the '80s.  Japanese food changed our relationship with fish."

  In New York the first sushi bar opened its doors in 1963.  But it wasn't until the '90s that New Yorkers truly discovered the vast world of Japanese cuisine that lay beyond raw fish on a rice ball ― and began to make it their own.

  Chefs from Japan have played an important role.  Matsuhisa Nobu's restaurant, Nobu, introduced some traditional Japanese recipes, delighting the public and influencing trendy restaurants of all types.  We can see it in the emphasis on simplicity, freshness and quality of product.

  With Nobu, New Yorkers' tastes and vocabularies developed.  Ten years ago, when Ono Tadashi became the head chef at a famous restaurant, the owners left out any mention in the menu of ingredients like yuzu and shiso, because the strange names made customers uneasy.  Today, at Ono's own restaurant, Sono, waiters proudly recommend the yuzu cocktail and shiso margarita.

  If you had to label Sono, you'd call it French with a Japanese accent.  "Japanese cuisine is a cuisine of ingredients; French cuisine is one of technique," Ono explains.  "So I combine the two.  I'll take fish and season it with miso, which preserves and brings out the flavor.  That's very Japanese.  Then I'll turn to French technique in how I cook it."

  Ono says that changing a traditional recipe would be viewed as not correct in Japan.  But mixing and matching international cuisines is what Americans do best.

  One key reason why chefs adopt Japanese cuisine is its healthfulness.  Homing in on Americans' increasing attention to their bodies, chef Michel Nischan wanted to create a menu for his restaurant using no butter, cream or foie gras.  "I was nervous," Nischan says.  "Without those ingredients, people imagine food won't taste good."

  He then turned to Japanese recipes for inspiration.  "I've had a lot of doubters give us big hugs," says Nischan.  "Americans have realized Japanese food is healthful without giving up flavor."

  Few foods other than Japanese have the advantage of appearing both diet-friendly and trendy.

  Trendiness aside, there is a limit to the adventurousness of American taste.  Nish says that his customers stick to the old favorites when it comes to one category.  "With traditional Japanese desserts, you get a tiny taste of something sweet or you get something mild.  The philosophy is not to overwhelm your taste buds or your appetite once the meal is over.  But Americans want their ice cream and chocolate cake."

  Ono found this out the hard way when he opened his restaurant last year.  His first dessert menu offered kuzukiri.  It wasn't popular at all.  "Alas," he says, "Americans were not ready for that yet."

"Are you Dr. Alexandra Ho?  We are looking for doctors who can leave for Mozambique immediately, to work on the cholera epidemic there."  And so, in the corridors of the MSF-Belgium office, my mission to Mozambique started.

  The first case of cholera in Beira, Mozambique's second largest city, was reported on 26 January, 1998.  Four days later, there were 245 cases in Beira alone.  In the light of these catastrophic developments, the government of Mozambique appealed to the MSF for emergency assistance.

  My team arrived in Beira on 7 February and went straight to work.  We took over a disused warehouse and converted it into a Cholera Treatment Center (CTC) in three days.

  On the first day alone, 15 patients did not survive the transfer from Beira's Central Hospital to the CTC.  It was the first time I had witnsed so many patients die in such a short time.  Things got worse the next day as patients continued to flood in.  Within 24 hours, more than 370 were admitted.  We dashed from patient to patient.  At the end of the day, we were exhausted.

In the first two weeks, we treated more than 1,500 patients in the CTC.  Many of us worked 20-hour shifts, seven days a week, until more local medical staff could be sent to Beira.  The Mozambican health authorities mobilized nearly all their doctors to fight the epidemic.

  The strain took its toll on everyone.  Although I was completely exhausted, I could not sleep.  I was disturbed by the many deaths I saw.  The situation was overwhelming, and I began to worry whether we had done our best and whether we could have saved more lives.

  A veteran MSF volunteer noticed my distress, and told me that we would soon see the light at the end of the tunnel.  The fatality rate usually falls within two weeks of the start of this program.  He was quite right.  From day 10 onwards, the number of new cases admitted finally fell below 100 a day and, after that, hardly anyone died in the CTC.  Every day, the situation continued to improve.

  One of the most important lessons I learned in Mozambique is that I should never give up.  There was a 21-year-old woman near death with a high fever.  But she finally pulled through thanks to the care we gave her.

  All throughout my university years I wanted to work for MSF.  Then two and a half years into my career as a doctor, I was finally able to take a six-month leave of absence from my hospital to fulfill my dream.  It has been a very enriching experience.  I feel that my work at the hospital has become more challenging as a result of what I learned on my mission.