First, forgive me if any of this makes little or no sense. I have been fighting a 38.3 (about 101F) fever over the past two days, a slightly lower fever in the 37C (98-99 F)range, along with what can only be described as bronchitis. The doctor told me that essentially everything in my throat is inflamed and that I essentially have bronchitis combined with a severe viral infection. My normal body temperature is around the 96 – 97 F range, so even having a temperature that is 98.6 (the average) is high for me.
Anyway, not really the point of this post. Now, some things I am going to say in this post are going to sound crazy and downright out of this world, but I assure you that I was there, and this is what really happened. What I am going to share with you today are instances of my various visits to Japanese hospitals since I have come to Japan. Please note, that there are hospitals out there that are not as ridiculous as the ones that I will describe here, but being in a relatively small town that does not have a lot of money, I guess this is what we get? My rather nicely edited Pokemon image refers to the ridiculous amounts of medicine one receives from Japanese hospitals whenever you go (5 – 6 different meds for a cold is a little much, wouldn’t you agree?), which I will discuss later.
Episode 1: May we give you stitches?
So, this story goes back to when I first came to Japan.Maybe it was because my nerves were shot because of promises not kept by my city’s Board of Education as listed in my contract, maybe it was excitement because it was my first day of work, or maybe I just was being stupid. However you look at it, it doesn’t change the fact that I cut my finger with a knife while cutting a kiwi. At first I thought I had just nicked myself as I did not feel much pain. I quickly put my finger under some running water to assess the damage when I noticed that the blood was gushing out. Also noticed something white that I only assumed was bone. I had really done a number on myself. I happened to be video chatting with Jun (who was still in America) at the time, so he helped me stay calm, as I was totally freaking out, and walked me through getting my finger bandaged up in a towel to stop the bleeding as much as possible. After I had calmed down a little, I called my boss and told him that I had cut my finger really bad and needed to go to the hospital. Maybe he thought I was overreacting, but the first thing he said to me, “Did you put a band aid on it?”
My initial reaction was telling my boss that he was an idiot. If I just needed to put a band aid on it, I would not have called him. I told him that I was pretty sure I saw my bone and I needed to go to the hospital immediately to get stitches. He seemed to think this over for a few minutes before saying he would drive to my apartment and take me to a hospital. Once he arrived and noticed that my white towel was turning, well, not white, he seemed to understand the severity of the situation. I am still freaking out, which is only to be expected if you ask me, and he tells me to remember the route we are taking to the hospital as I will need to go back for check-ups on my finger. Yeah…I’ll google map it later. When we arrive at the hospital, I first have to register as a new patient. This took somewhere around 10 minutes as I answered questions on their little hospital questionnaire thing. My boss was not allowed to write for me as it all had to be done by the patient. Good thing I cut a finger on my left hand and not my right. Once we are finished and the nurses looked over my questionnaire, they call my boss aside and start asking him questions. After another 5 minutes, my boss comes backs to me and asks, “Kyasarin-san, what would you like to be called?” Apparently, this hospital does not deal with foreign patients often. The nurses were not sure if I wanted to be called by my first name, my last name, my middle name, or some combination of the three.
You have got to be kidding me…
By this point in time, the pain in my finger was starting to kick in and I was getting downright agitated at how long it was taking for them to actually get to the immediate issue that was my bleeding figure. I told my boss I didn’t care what they called me, just as long as they were going to fix my finger.
Deciding that my last name plus “sama” was suitable for the situation, the nurses then asked me to wait until the hospital officially opened at 9:00 am. The current time was 8:40. Really? No emergency care in this country? Left with no choice, I sat in the waiting room as other patients arrived and looked at me nervously. Once 9:00 rolled by, a nurse took me into another room and my boss remained in the waiting room. So much for someone being a translator for me… Once I was in the other room, the nurses wanted to check just how badly I had cut my finger. They removed the towel and kind of did one of those nervous giggles saying, “oh, it really is deep!” What, did they think I was lying? Sheesh. Then, the strangest thing happened. The nurses asked me to give them permission to give me stitches. I was kind of floored by this, but then, remembering what country I was in, knew that them asking had to have been the whole Japanese politeness thing. Looking back, I was really being rude and being insensitive to their culture, I asked the nurses what they would do if I told them “no” to their request. Did not seem to know what to do with that one. They waited for an answer before calling the actual doctor in. By this point in time, I had very little hope for the doctor. I wouldn’t have been surprised if he put his white coat on backwards or came in wearing pink bunny slippers. Thankfully, this doctor had all his screws tight. He comes into the room and sees that I am clearly in pain and freaking out and tells me that everything is going to be fine. He briefly walks me through the process before removing the towel from my finger and injecting my finger 3 times to numb everything. He then inserts 4 stitches to totally stop the bleeding and cleans up my finger before bandaging it up (see above picture). While he is doing all this, he does a good job at making small talk with me and I learned that he actually studied medicine in America and that he lived in my hometown (well, very close to my hometown) for a month doing a short internship. Finally, someone with more than half a brain is really all I could think about at the time.
Once things were done with the doctor, I get a sheet of paper explaining what medicines I should receive for the pain – I think I was prescribed a total of 3, but I can’t remember right now. So, I pay my 3000 yen for my stitches and then go to the building next door where I pay another 1000 yen for my medicines. Now all patched up, I assumed that I was going to be taken back home to relax and recoup so I could go to work the next day. No such luck…my boss then drove me to school where all the teachers thought it was ridiculous that I was expected to be there. After feeding me lunch, the school nurse took my temperature because I was not looking to good. I had a slight fever, which was to be expected, and without asking for permission, told the school principal that I was being sent home. Had a week of going back to the hospital everyday to get my finger “cleaned” which pretty much meant that I got some rubbing alcohol put on it to disinfect any germs that might be there. Around 500 yen every time to do this and after awhile I asked if it was really necessary since I could clean it myself at home. That was the end of my paying 500 yen. After a few weeks, I was finally able to get my stitches taken out and my finger, for the most part, all better. I am not sure everything healed properly as I can still feel the line were the stitches were holding my skin in place and there is some mild discomfort when I press down on the area. Still, at least the decision was not to totally cut off my finger, right?
Episode 2:Mumble mumble, pee please, mumble mumble
Back in October, all the government sponsored ALTs (a total of 8 of us) had to go for our yearly check-ups. We do not get to decide what hospital we go to and, as it turns out, the hospital that we go to is the one that will do the checks for us ALTs the cheapest. Before going to this particular hospital I had already essentially had a check-up at a previous hospital (see next story) and I asked my boss if I could just get the results of those exams in place of going through the same ordeal again. I never got a response. We were also told we were going to have some blood drawn, so we needed to fast. Our boss made our medical checks for the afternoon (2-ish) and we were told with a smile that we could not eat lunch. OK, just sleep in and then go to the hospital, no problem. Wrong…we had to go to work in the morning. So, work from 8 am until 1 pm and then bike to the hospital and undergo a 2 hour medical exam, then food. Our boss and people from the Board of Education did their medical checks in the morning.
Anyway, I biked to the hotel with one of my co-workers because I was not sure where the hospital was. When we arrived, the hospital was actually not within the working hours, so we had to wait for 30 minutes for the place to actually open. Now, the outside of this place literally looks like something from a horror movie – think Silent Hill-esque. The building pictured above is the only picture I could find on the internet of the hotel we went to. Doesn’t really do the creepy side of it justice. While we were sitting in the waiting room (aka three sofas in the middle of a hallway) we were looking around and quickly took notice of the newest piece of equipment was the small flat screen TV in the lobby. The walls were probably never painted and the only color were some old plants that clearly needed more water and the pea soup colored couches we were sitting on. When I went to one of my elementary schools after the exam and told them about the, they all started laughing and said they were sorry. Apparently, this place is considered one of the oldest and crappiest hospitals in Saitama…not the entire hospital “chain,” but the branch in Kawagoe. Lucky me…
We were given ridiculously long questionnaires to fill out by a nurse who looked totally overwhelmed by the number of white people in the hospital. When we were done filling out the forms, we were ushered through a series of test assembly line style. Up first on the to-do list was a hearing test. One-by-one, a nurse walked us to a room in the back of the hospital where we were instructed to put on a pair of giant headphone and push a button whenever we heard a noise. Now, I don’t know about the hearing test you guys have done, but the ones I have done consist of the doctor pushing a button and a noise of a certain frequency plays. This test was totally different as the nurse just played around with some dials on a beige box. In summary, there was a constant humming noise. To top it all off, the room we were in had all its windows open and was located right next to a busy street. Bonus points for hearing things over traffic noise? The nurse must have turned the dial all the way up because she seemed concerned I could not hear anything. She asked me what I could hear and I told her “the sound of traffic and a buzzing sound.” I was then told to ignore the cars and we would start the test over. Goodie.
Next, we had a check X-ray to make sure we did not have tuberculosis. Apparently, Japan does not do the skin test, but instead wastes money taking a chest X-ray? I thought people were vaccine for this when we are children…After the X-ray was a vision test which was pretty much the same except instead of reading the alphabet, we had to look a series of the letter “c” and tell the nurse which direction the “c” opened (up, down, left, right). The nurses spoke no English, so I am not sure how the ALTs who don’t know Japanese did with this part of the medical exam. After we had our EKG tested. This laughed halfway through this exam and the nurse gave me a confused look. First, we had to lie down on a table, then the nurse attached clamps to our wrists and ankles, to finish things up, we had eight different suction cup electrodes stuck to our chest (this is where I started laughing) complete with an assortment of colorful wires. I felt like I was being experimented on by Dr. Frakenstein. The machine where all the wires hooked up to did some beeping and then a long sheet of paper printed out – no viewing screen. The nurse took that, told me I was finished, and handed me a paper cup to pee in. You read that right, a regular old paper cup. I went into the bathroom to get the peeing over with to find that there were no sanitary wipes. I went back out to ask the nurse for one and she looked at me like I had four heads. “Pee, please,” was the response I got. Last on the list of exams was the blood test. This part totally grossed me out. First, the nurses were not wearing any gloves. There was a jar of alcohol wipes to sterilize the skin before inserting the needle, but I failed to see the point when the nurse took them out with her bare hands. My nurse ended up taking too many, dropped a few on the table, put one on my arm, and put the rest back in the jar without closing the lid. Ew… She took my blood, which went smoothly, but when she took the needle out and started transferring small amounts of blood into smaller containers for testing, a drop or two fell onto the table. The nurse took a nearby box of tissues, grabbed one, and wiped up the blood. The last step of the day was talking to a doctor who I swear only said ですね(desune) and mumbled the rest. Results were given to the Board of Education where our boss opened them first (what about patient confidentiality?) and then sent us a copy in the mail. All in all, not a pleasant experience.
Episode 3: Show me the medicine!
I’ll keep this next one short because I have already done a lot more typing than I was expecting. Now, if you ever go to a hospital in Japan, you can expect to leave with more medicine than you know what to do with. Going to a hospital is not a very enjoyable for anyone, but I find it even more so in Japan – at least at the hospital I go to. When you arrive, you put your hospital card in a box and the receptionist gives you a piece of paper with a number on it. This is now your “identity” for the day. Your name is not called, but the number on your piece of paper is. Just as well, Japanese people get flustered when they see my name anyway. So, you wait an hour or so (because everyone in Japan who has a cold reports to the doctor) to see the doctor. Whenever I get sick, I have to have a doctor’s note proving that I was sick to give to my boss otherwise the day is considered a “vacation” day and not a “sick” day. Sheesh, what am I, 5-years-old? Usually, when I have a cold, I sleep for a full day and the next day I am within functioning range. Monday I had a fever of over 100F and told my boss I was not sure I could make it to the hospital alone and just wanted to rest all day. That did not sit too well as I had to get a doctor’s note and was told “please go to the hospital.” So, in freezing temperatures (it snowed like crazy that night) I rode my bike to the hospital, sat in the waiting room for an hour, saw the doctor for 5 minutes, was given my prescription for medicine, paid, and went home. The picture above is all the medicine I received for my bronchitis: 1 generic cold medicine (the white powered which you have to swallow with water), white pills to help the inflammation in my throat go down, round white pills to “kill new germs” entering my body, other round pills to reduce fever, and some cough syrup. One reason doctors in Japan, give so many drugs is that local patients demand them. The real reason is that this is where the hospital makes the money. As one person put it:
In Japan, doctors only get about $35 for a patient visit. Hence the 5 minute appointments, getting a number deli style and checking on the internet when your turn is near.
However, doctors also get to bill the government/health insurance agencies a fee for prescribing drugs which can be as high as the visit fee for EACH drug; hence the incentive to give you a few drugs.
Also, still many doctors dispense the medications themselves or did you ever notice how the pharmacy is right next to or across the street from your doctor. So they get to capture the retail mark-up as well.
Although generic drugs are available in Japan; they have less than 20 % market share. This is because the MR (Medical Representative or Sales Rep in Western speak) is close with the prescribing doctor and organizes gokons (drunken group dates where it is easy to lay the nurses….) as well as probably takes the doctor out to fuzoku as part of his “sales duties.”
In summary, doctors make more on the drug end than the seeing patient end combined with J blowjob capitalism.
Another thing I read on the internet is something called IV cocktail. Get a cold, go to the doctor, and get an IV. That will put the bounce back in your step. Some doctors don’t always offers IVs to people who have a cold, but if you really want one, just ask the doctor. The doctor will usually oblige. Does this happen in America?
Episode 4: the pink chair
I’ll keep this really short. I went to a woman’s hospital upon recommendation of my host mom to get a Japanese prescription for birth control. Japan is still in freak out mode about the stuff, so I had to do a full medical check at the hospital before I could get the medicine (and I will have to do a mini check for 3 – 4 years after taking the medicine to make sure I do not get cancer from it). I was frustrated with this, but nothing put me over the top more than getting a pap done by a Japanese male doctor. I was not even asked if I was comfortable with having a male doctor – which I am not. So, they sit you down in a pink chair, you wear one of those nightgown things, a curtain is drawn so you can’t see the doctor and they can’t see you, the chair moves on its own to put you in the proper position, without warning something is stuck you know where, then another something is stuck you know where and a TV in the room turns one, the doctor happily says “your uterus!” and turns the TV off. Chair then rotates back to normal, doctor leaves, curtain stays where it is, you get dressed, go into the next room, get a picture to take home of your uterus, have to come back in a few weeks to hear the results. It was the most ridiculous process ever. Now, every time I go i request a female doctor and I feel much more comfortable. Next time I have to do a pap, I am going to ask for there to be no curtain…that was too freaky.
In the future, Jun and I will definitely be moving to a town with better hospitals