In Sickness and In Health

by industriousants

Two weeks ago, on a gorgeous Sunday morning, Matt took off early to go surfing. Just driving out to his favorite beach takes half an hour, and even on days where the waves are bad, he’ll stick it out in the water for at least a couple hours. So when I heard the car roll into the parking lot uncharacteristically early, I knew something was up. I watched as he emerged from the car with a frustrated look on his face and a 2-inch bloody gash across the top of his head. Asking him what had happened almost seemed redundant, because we’ve had more than one discussion about how sharp the fins on his surfboard are, and it seems to be a fairly common injury among surfers. In some ways he was lucky that the fin got him across his skull, and not a fleshier part of his body where the cut could have been much deeper and wider, or worse, across his face.

After jumping on Skype and assessing the damage with his dad (a doctor), he finally heeded my original advice that a trip to the emergency room was warranted, and that stitches were probably inevitable. It’s not what he wanted to hear, but he conceded willingly. The hospital we visited was a simple clinic that deals with cuts and breaks. The facility was a bit older than other’s in town, complete with a 1960’s institution-green paint job, but they were one of the few places open on a Sunday, and they got the job done quickly and efficiently. 7 stitches and no surfing for 10 days. Matt was bummed. Donning on his head a large bandage and a mesh net that made him look like a tough prison inmate, we headed home. I made him a greasy meal of eggs, sausages and chocolate chip toast to try and raise his spirits some. He dug out his favorite hats from the closet and that was the last that many people saw of the top of his head for the next couple weeks.

Typically, neither of us is the sort of person that goes running to see a doctor. Matt grew up with his own personal live-in physician, so I think he just became accustomed to turning to his dad for medical advice. Later, when we lived in Minneapolis, our insurance was quite limited (read crappy), so we self-medicated and home remedied ourselves whenever possible. Even in Japan, where the care is mostly subsidized by the government, we try to ride things out so as not to inconvenience Japanese speaking friends with the hassle of translating, not to mention that sometimes getting sick here draws negative attention. We first arrived in the country smack in the middle of a swine flu epidemic that was spreading through our prefecture. Teachers wore surgical masks religiously and the size of my classes slowly shrank as students started dropping like flies. Disinfectant sanitizer was everywhere and anyone who so much as sneezed was given the evil eye. In the middle of all this, I woke up one Saturday in a hot sweat and found that I could barely lift myself out of bed. We were fresh in the country, barely knew any Japanese and were edgy about the early impressions we were having on new colleagues and friends. I never went to see a doctor out of fear that I would be immediately shipped back to Canada and blamed for bringing the virus with me from abroad. To this day, I can’t say for sure if I had the swine flu, but whatever it was, it was powerful enough to knock me out cold for the entire weekend and left me feeling exhausted for weeks after that. It also happened to be contagious, because I ended up giving it to Matt, who can attest of its great strength. We both threw as much orange juice, weak over the counter Japanese meds and sleep at it as we possibly could. I have never missed Nyquil and Tylenol so much as I did then. Eventually we bounced back, but it was a miserable, drugless, recovery.

The first time I actually visited a doctor in Japan, I wasn’t even sick. Every year my school requires teachers to do a mandatory health check. Depending on your age, you must take a variety of tests. Mine included a urine test and blood work, as well as a chest x-ray, sight and hearing test. Older teachers have to drink barium milkshakes and get their guts inspected. You can even apply for an optional MRI if you are willing to pay the extra 100$. Overall, my results were good, but I was pretty surprised when I was told that my blood sugar levels were too low and that I should be monitoring them closely. They letter grade your check-up here, like a high school report card, and I scored a C on my glucose levels. My family has a history of diabetes, so the results sent me into a mini panic, until I talked to Matt’s dad who took a look at the results and said that by North American standards my sugar levels were just fine. Actually, they were the sort of results most people envied. To learn that two developed nations could have such different standards of measuring a person’s health was an eye-opener and it would not be the last time I encountered differences in our systems of diagnosis and treatment. At first, it made me somewhat distrustful of the Japanese level of health care.

It was Matt’s mysterious rash-incident that loosened me up a bit. A couple weeks after arriving in Japan, Matt’s chin started turning red and bumpy. His goatee hid it for the most part, but anytime he shaved the area we could see that there was obviously something not right happening there. Over the course of 4 or 5 months he tried everything, from peroxide to anti-fungal creams. Nothing worked at ridding his chin of the strange rash. I thought for sure it had to be a sub-tropical infection of some sort. We unofficially dubbed the ailment the Chin-Kansen, a play on the name of the fast Japanese trains, the Shin-kansenkansen, meaning both ‘main line’ and ‘infection’. Fearing that his chin-kansen would spread faster than a bullet train, we finally recruited a Japanese speaking friend who accompanied us to see a local dermatologist. The doctor’s diagnosis- vitamin B deficiency. His remedy – vitamin B pills and a topical vitamin B cream. He also told Matt not to shave for a while. I thought the guy was a certified quack and that his prescription was absurd. Obviously, what my husband really needed was some serious antibiotics or strong antifungal meds. How could that ugly red splotch have anything to do with a little less spinach in his diet? But after a week of the treatment, the rash cleared up almost completely and it hasn’t been an issue since. I was utterly dumbfounded.

Since then, I’ve been a bit more open-minded about doctors in Japan. It’s a good thing too, because between the two of us, we have probably visited close to every sort of hospital in town. I guess it’s not that surprising seeing as Matthew is a fairly active guy, and as of late, I’ve been a fairly pregnant gal. Matt has had a total of 11 stitches sown into him in Japan; 7 for his head, and 4 for his leg when he needed a strange growth removed last year. He also had a minor car-meets-bike accident, which resulted in a thin layer of skin from his heel being torn off his foot. In the end, it just needed some cleaning and disinfection and a day or two of using crutches.

Aside from Matt’s most recent surfing adventure, being pregnant has been the most intensive health issue we’ve dealt with in Japan up to date…and it’s obviously far from over. In less than a month I am scheduled to give birth. It’s one visit to the hospital that won’t be a surprise. It won’t matter if there is a translator at my side, or a personal understanding that everything happening to my body is completely normal, I know it will be overwhelming. I hope I don’t yell at anyone, and I really hope that Matt doesn’t pass out.

In light of all this, it’s a good thing that we have had a chance to test the waters of the local system over the last couple of years. Coming to a point where I feel like I can trust the medical professionals involved in my care helps a lot. The last thing I want to do be doing on the birthing table is second-guessing all the procedures happening and cursing at all the masked faces trying to help me (but maybe the cursing part is unavoidable on this sort of occasion). Of course, I don’t want to just blindly accept everything either, and there are definitely aspects of medical treatment in Japan that differ from what I grew up with and would prefer. Thankfully they are not big enough to make me want to run back to Canada to have this baby. The only reason I would choose to be home for the birth is to be closer to my family, but logistically it wasn’t the most convenient option.

People ask me if I am scared or nervous about having a baby in Japan. Overall, I don’t think so. For me, what’s scary is the actual ‘having a baby’ part. Whether I have it here or there, it’s going to come out in the same way babies have come out since the beginning of time…painfully, messily, and miraculously, at least that much I know is true. As for the medical side of things, I’m not really nervous. For one, Miyazaki prefecture is rated as one of the top regions in the country for obstetrics, even higher than Tokyo apparently, which might have something to do with the higher than average birth rate in these parts. In any case, that alone gives me some peace. Other than that, if I ever feel any doubts, all it takes is one look at the World Bank Infant Mortality list to feel a little more assurance. If I was in Afghanistan or Mali or Chad, maybe there would be statistical reason to worry, but I’m not. I’m in Japan, and I feel pretty fortunate to be here.

You can check out world infant mortality rates here:

Our health care adventures will surely continue as we approach a chapter in our lives where we don’t just have to care for ourselves, but for the life of a new third party. Hopefully we will continue to remain optimistic about the care we receive in Japan, and that it will prove itself worthy, but likely there will be bumps along the way. I suppose it goes with the territory of neither speaking Japanese nor the secret language of Shrill Baby Screams. In time, I hope we can master both. I’ll keep you posted on our progress.

May 26, 2011