For three decades in Manhattan, Dr. Masahide Kanayama built a reputation as a meticulous endometriosis surgeon whose operations ended years of pain and helped many women have children. Now the 63-year-old physician, a Korean Japanese Christian who openly credits his faith for his surgical gifts, is battling an extradition request from Japan. Prosecutors there say security cameras in March 2015 captured a hooded man dabbing oil on pillars at Naritasan Shinsho-ji Temple and, less than an hour later, on railings and a donation box at Katori Jingu Shrine. They allege the figure matches a driver of a rented Toyota Prius tied to Kanayama, who had flown in from New York days earlier, the New York Times reported.
A religious act or a criminal stain
To Japanese authorities, the oily smears defaced centuries-old religious heritage. To Kanayama and his lawyers, what prosecutors call vandalism was, even if committed, a non-damaging religious “anointing,” a biblical practice of consecration. They argue translations of old YouTube remarks attributed to him have been misconstrued, that damage was minimal or non-existent, and that the case reflects hostility toward a tiny Christian minority. His counsel frames the prosecution as political overreach unworthy of the treaty process.
The extradition stakes
A US federal judge in New York certified the extradition in 2023, finding probable cause and a US legal analogue in criminal mischief; a second judge agreed on review. The State Department has declined to block transfer but is waiting while Kanayama appeals. If the court rules against him, he could be sent back to face trial and a penalty of up to five years of hard labour. The outcome now hinges on the appellate panel that heard arguments in October and can rule at any time.
Faith, vocation and a method
Kanayama’s biography runs through an evangelical conversion at 17 in Tokyo, Jesuit-run Creighton University, medical school in Wisconsin, and residency at the Mayo Clinic. In New York he taught at Mount Sinai before founding the New York Endometriosis Center, attracting patients from around the world. He developed an excision technique that fans say is painstaking and organ-sparing, and created a clinic environment of rice paper, bamboo and a meditation room to lower stress before and after surgery. “Healing is not only physical, but also mental, emotional and spiritual,” he says. He worships at Times Square Church, raising a marked Japanese-language Bible during services and saying he experiences his operating room as a calling: medicine as service to God.
Patients who fear losing their doctor
Women who spent years dismissed by clinicians describe his approach as life-altering. A Westchester entrepreneur who endured fatigue and pain says he immediately recognized her disease and validated her experience; she has had two operations with him. A Manhattan writer recalls a half-dozen doctors before his 2022 procedure ended her pain. Both say his removal would strand patients who waited months for a slot and see no equivalent alternative.
What investigators say they found
Japan’s case links the shrine incidents by timing and clothing, connects the man in videos to the rental car, and relies in part on 2012 online clips in which a speaker authorities identify as Kanayama discusses pouring oil on shrines. Prosecutors call the videos evidence of motive and intent, and say the country has an interest in stopping a pattern of attacks on historical sites. Shrine officials filed statements describing blackish stains on wood at Narita and oily traces at Katori that later faded but were visible up close. Defence lawyers dispute identity, translation and intent, and insist the law should not treat an act of purification as desecration.
Politics, principle and precedent
Supporters see a surgeon in good standing targeted for minority faith in a nation where Christians are about one percent of the population; detractors see a suspect refusing accountability for marked religious structures that draw millions of pilgrims. The legal question for U.S. courts is narrower: does the record clear the treaty’s bar of probable cause and dual criminality, leaving policy judgments to the State Department. For now, the department has signalled deference to the request, with a pause while appeals run.
A life’s work in the balance
While the case moves, Kanayama keeps operating and praying. He quotes Micah about doing justice, loving mercy and walking humbly, saying he feels “totally broken” yet uncrushed. If he loses, he faces a return to his native country not as a visiting healer but as a defendant, with his clinic, patients and calling abruptly interrupted. If he wins, he still must live with a decade-long cloud over his name. Either way, the tight braid of faith and vocation that sustained his career now defines the fight to save it.
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