Northern Italy here, I have a tree of nespole and it's pretty common even. Not the most common, but not forgotten here.

While "nespole" is apparently sometimes called "Japanese Medlar" in English, they are more usually called "Loquat" (Eriobotrya japonica): https://en.wikipedia.org/wiki/Loquat

They are quite different and not very closely related to the true "Medlar" (Mespilus germanica) described in this article as forgotten: https://en.wikipedia.org/wiki/Mespilus_germanica

You might mistake them in a black-and-white photo, but otherwise are easily distinguished. Neither is well known in most of the US, but the loquat is commonly grown in California yards while the medlar is a true rarity here.

It's quite low maintenance and low effort for a fruit tree, and as long as someone likes medlar (don't count me in), why not?