Thursday, July 12, 2007

Japanese Health Care Part 2: Insurance health Checks

Once a year, Japanese employees are requested to take a full health check, provided at the company’s expense, for insurance purposes. Most consider it a free doctor’s visit and are happy to oblige. However, knowing I speak very little Japanese, I was less than eager. No truly good afternoon begins with your (male) Board of Education supervisor trying to express in broken English that he wants you to pee into a cup.

The cup’s only the start. My supervisor quickly excuses himself, leaving me with a Japanese nurse who chirpily litmus tests my sample. This isn’t in a private room mind you; the urine lab has been hastily set up in a public corridor on the second floor of the town hall. She measures my height while the test registers, then apologetically tells me that my urine appears to be slightly less acidic than normal (at least I assume that’s what she was saying – my years as a biomed student taught me how to read these things for myself). I attempted to explain that this was most likely due to the 5 medications I was on – painkiller, anti-inflammatories, antibiotics, multi-vitamins and iron supplements. She seemed to accept this and let me through – but not before telling the next doctor about my urine problem. In fact, all the doctors got told about this, regardless of their area of expertise. I failed to see how the pH of my urine was relevant to my long distance vision, for example.

Standard tests like weight, blood pressure and lung capacity were no real biggie because I already knew what to expect. Corneal examination, I did not. They ask you to put your head under a black cloth and look through a lens framed in a little box, just like an old-school camera. You there staring at a little green light for close to a minute, wondering if something is supposed to be happening, when suddenly you’re blinded by a light brighter than the sun exploding and fall backwards out of the box. Obviously I’ve been in Japan too long, because when the nurse picked me up asking if I was OK, all I could do was state the blatantly obvious:

‘I was surprised.’

Next was a test which I can only assume was similar to an ECG, but was more like a scene from Alien Autopsy. This was followed by a blood test, where I successfully freaked out the nurse with my insistence on watching the needle penetrate my vein (…I have a needle thing…).

Last on the list was a chest X-ray, where you’re permitted to keep your shirt so long as you lose the bra. Here I demonstrated my total gaijin superiority by jumping two Japanese women in the queue – apparently they do not know the legendary remove-your-bra-through-your-sleeve technique. A happy little snap by the most nervous Japanese man in existence (Gaijin boobies! Get them away! AWAY!), and I was free… for another 12 months.

Japanese Health Care Part 1: Being ill in Japan

The JET program insists you be in impeccable health before coming to Japan. Probably because they know that sending a foreigner through the healthcare system is like trying to hide a junior high schooler’s underwear from the public eye: pointless.

So when I woke up crook as a dog and saw the pouring rain out the window, I decided to be stoic and go into work. After teaching the ichinensei for the first period, I gave up on that particular act and stumbled to the school nurse’s desk. She took my temperature to prove that the cocktail of Australian drugs I’d already taken had reduced my fever, but concluded that I was genuinely ill. We decided upon an excursion – the school nurse, one of the English teachers and I – to the local GP. It was really just a lovely excuse for the other two to take a break from school, but I was glad for the company.

So along we went, me feeling rather sorry for myself, but trying to perk up enough to show the proper gratitude to my carers. Apparently was is one of those occasions when my foreignness worked to my advantage – the doctors were so excited to have a gaijin in their midst that they immediately ‘bumped me to the front of the queue.

Now, I essentially had 3 problems – my ears hurt, my tonsils were infected, and my lymph nodes were swollen. Back home, this meant you would tell your doctor 3 symptoms. In Japan, it means you see 3 doctors.

First the ear doctor. He looks in my ears for 0.2 seconds, declares that they’re fine and stamps a big cartoon picture of a pair of ears onto my sheet. It took all of 45 seconds for us to go from the waiting bench, in to see the doctor, and back to the bench again. We used the next few minutes for an impromptu English lesson on medical terminology using electronic dictionaries, before hitting the next doctor. He brushed his fingers under my chin and stamped my paper with a happy looking lymphatic vessel. If I was beginning to feel neglected, my next doctor would ensure I got plenty of attention.

It’s par for the course for gaijin in Japan to be subject to on-the-spot eikaiwa, often being approached on the train or in the street by locals wanting to practice their English. I made the rookie mistake of assuming that this rule did not apply to sick and suffering expats. Something was clearly amiss when I was greeted by an altogether too chirpy doctor. The following is a transcript, word for word, of our conversation. Italics indicate parts of the conversation that took place in Japanese.

Me: Excuse me. Please look after me…

Doctor: Hello!

M: Oh… hello…?

D: So… what… bring you here today?

M: Well, my ears really hurt, and so does my throat. It really hurts when I swallow, and my lymph glands are pretty swollen…

D: I see. Where are you from?

M: Huh? I’m from Australia

D: Oh really? Where?

M: …ummm….from Melbourne

D: Oh! I went to Cairns last year. I went hot air balloon!

M: I see.

D: I saw red kangaroo in a field!

M: That sounds nice.

D: Mmm. Yes. It was wonderful trip.

M: Mmmm.

D: Mmmm.

M: ……..so about my infected throat…

D: Ok, say ahh!

M: Aaaaahhhhh

D: Hmm, OK. So how long have you been in Japan?

M: Ummm… 11 months.

D: Oh! 11 months!

M: Yes.

D: So you’re a teacher?

M: Yes. I teach at the local junior high.

D: I see

M: …

D: So, did you take any medicine yet?

M: Yes, it’s Australian medicine though.

D: Do you have it with you?

M: It’s these (hands over the medications, realizing too late how stupid that was seeing as these particular drugs are illegal in Japan (Advil and Panadeine, for those playing along at home).)

D: I don’t know it. I’ll nurse research it.

M: OK

(the nurse takes the pills to her workstation to look them up)

D: So how do you like Japan?

M: Ummm…. It’s great.

D: Do you eat Japanese food?

M: Well, not recently, seeing as I’ve been too sick to eat…

Nurse: Sorry, I can’t find the information.

D: Sorry, we can’t figure it out. What is it?

M: (quickly taking back the pills and lying on the spot) Here, it’s this (points to ‘paracetemol’ in Japanese dictionary)

D: Ah, I see. Well, that’s OK.

M: OK.

D: ….

M: …..

D: So… have you eaten today?

M: Today? Umm… no.

D: Do you want an intravenous drip?

M: Sorry, I don’t understand…

D: Eto… do you need IV?

M: ummm, no, I think I’m OK.

D: Do you need blood transfusion?

M: What? No, I really don’t.

D: OK. I conclude that you have a cold. I will prescribe antibiotic. And garagara*. And medical candy.

M: Medical candy?

D: Throat lozenge

M: Ah.

D: And also use Australian medicine. It’s very well.

M: (and the prize for most obvious statement goes to…) Thank-you very much.

D: So, do you teach private English lesson? My daughter living in Kyoto

M: (runs for the hills)

*garagara = antibacterial mouthwash. ‘Garagara’ is the sound you’re supposed to make when you gargle.

Notice, and this is the perfect example of the average Japanese mastery of English conversational skills, how he doesn’t use English to help understand anything I actually need to know? Like medical information? Or what is actually wrong with me? No, instead he’s letting me sit there falling off my chair with malaise while he tells me about his hot air balloon ride over kangaroo country.

After all that nonsense, we move onto the pharmacy to fill the scripts (though I’m wondering why I need a prescription for soothers and mouthwash), and head back to school where I promptly pass out at my desk. Once the teachers notice, I am mercifully sent home.

I spent the next two days battling a vicious fever with a spattering of Japanese antibiotics and all the aussie drugs I can hurl at it. I hope I never have to go in for something more complicated than a ‘cold’.

amy