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