Monday, August 2, 2010

Things I won't: Doctors

This is the part in the farewell entries where the bile starts to build a little bid.  Which wouldn't be a problem, except that there's not a single competent doctor in a thousand miles to take care of that.  I mentioned in one of my first entries that everything in Japan is a cold.  And boy, I was not lying.

Seriously.

Everything--and I mean everything--in Japan is a cold.  EVERYTHING.  In the case of my wife, she had mono and pneumonia misdiagnosed as colds.  By comparison, I got lucky.  Just a mis-diagnosis of food poisoning (twice) and the flu as colds.  It's like the concept of science hasn't advanced past the point of illness originating from demons quarreling within your four humors.  Just grope the patient a bit, stick a thermometer under their tongue, and then go into the office and toss a dart at the board and that's what the illness is.  Except this is what the board looks like:


The blame, in large part, I think can be laid on the "you have three weeks of vacation from work every year, except you can never take them and also you have to work holidays and weekends for free" attitude that permeates corporate Japanese society, and therefore, society as a whole.  Calling everything a cold basically acknowledges that, yes, there's something wrong inside your body, but not enough to prevent you from putting in 14 hours of overtime, so back to work, bitch.

Because Japanese people have been essentially programmed that "illness = cold," they don't even bother with getting a medical opinion even when they really need it.  I actually saw one woman on the train moaning and wailing, clutching her stomach in agony and I suggested she go to the hospital.  "No big deal," she said.  "It's just a cold."

I was like "bitch, there's a head sticking out of your cooter!"

Japanese doctors are seriously something else entirely.  There's a doctor shortage in Japan (because anyone remotely competent to practice medicine leaves the country for greener pastures), and a lack of competition has devolved into a clusterfuck of ineptitude and apathy.  My wife has been suffering with pain in her neck and right arm for about a month and has been going to a rehab clinic to try and re-align her spine (apparently, even Japanese doctors think a cold localized in the neck and arm for five weeks is a bit suspicious).  After attending rehab nearly every day for a month, a doctor approached her after her rehab session and said--and I quote--"we have no idea what's wrong with you.  You can pay at the counter."

Ladies and gentlemen, I present to you a first-world country with a medical system that actually makes America's look like it has its shit together.

The worst part is, a few Japanese people I've talked to actually defend this Hippocratic Hiroshima by saying that it's not that Japanese doctors are inept, it's that they don't immediately swing for the fences and prescribe something to fix the problem.  This is not true.  In fact, prescribing medication is the one part of the job Japanese doctors do well.  I received an average of about four medicines per prescription when I visited the doctor.  The problem is that the medicine is worthless.  Seriously.  The only way Japanese medicine could possibly be more worthless is if they didn't bother removing it from the Tic-Tac box it came in so you couldn't even get the placebo effect.

But honestly, I think the problem is even more deeply rooted than the horrendous corporate culture, the fact that Japanese doctors all suck at their jobs, and that the medicine makes Children's Tylenol look like the bacta tank Luke hung out in at the start of Empire Strikes Back.

10 out of 10 Japanese doctors thought Luke was in here because he caught a really bad cold from the wampa

The fact of the matter is that if you you look hard enough, you can find the occasional doctor who didn't spend the entirety of med school snorting crushed-up suppositories off a tongue depresser.  True story: I had suffered with that toe injury for six months before the doctor (and I use that term loosely) whom I had been seeing every day of that duration finally suggested I get surgery.  I think he thought curing me would kill the goose that laid the golden pus-bubbles.

What followed the surgery was a long and painful four-week road to recovery.

A couple months ago, when my toe started acting up again and got about as bad as it had ever been in the space of a week, I went to the doctor, he looked at it, and gave me a look like "let's fucking do this" and cut into me that day.  I was up and around less than a week later.

No, the problem lies deeper than the incompetence of the vast majority of Japanese medical professionals (and to prove that I've been around the block enough to cast judgement, I'm sporting in my wallet no less than 16 doctors office membership cards), or the regimen of sugar pills the prescribe.  No, the problem stems from the language itself: from one single word, a word my first doctor said to me at the end of every single visit while I was struggling with that toe injury, and that nearly every other doctor had said to me before or since: "ganbare."

For those of you lucky enough not to know what this word means, it has no direct English translation, but "push yourself" or "do your best" are fairly close approximations.  I know what you're thinking: "nothing wrong with a little word of encouragement," right?  No, nothing at all.  Except that's not what this word is used for.  Because while the literal translation is "do your best," when it comes from someone in a position of authority or power, what it actually means is "you're on your own, chump."

Doctors in particularly love this one as a quick and easy substitute for actual medical advice.  I've actually heard it so much I'm inoculated to it to it and it just sounds like a cough or an "um, uh..." to me now.  So I suppose I should give credit where it's due: it's the only thing a Japanese doctor has ever successfully inoculated anyone against.

Bosses love this one, too.  With just a word, it absolves them of all responsibility to provide assistance, explanation, advice, supervision, or even a physical presence outside of their corner office.  "We have a lot of work to do this week and I really want to play Tetris, so you all have to work overtime.  Ganbare."

You can even use it like my head teacher in a class this past week when the task is impossible!  We were doing special fun lessons last week for the start of summer instead of the usual curriculum--just something for the kids to do before the start of summer vacation.  One of the classes was for building Legos, and for the older kids, the task was to assemble a fairly complex Lego Technic set.  If you've never seen one of these before, it's a pretty involved process.

The instruction manual outlines over 50 steps to turn your plastic pile into a mechanical marvel and they do not fuck around.  If it's not perfect, your shit don't work.  Cool stuff, though.

But halfway through, one of the students got stuck.  The instructions called for a piece he couldn't find.  He didn't lose it--I had been watching him and we turned the classroom upside-down.  I went through the instructions with him and he had followed them perfectly.  It was just missing from the original package.  By this point, he was pretty upset and I got the head teacher to come into class to explain the problem.  She tore his half-built Lego-kart apart piece-by-piece and told him to just rebuild it without the piece.  And as he sat there looking about as shattered as his former go-kart, out came that God damn word: ganbare.

No.

No.  Fuck you, no.  That's a fucking cop-out.  That's the biggest fucking cop-out in the entire culture.  In the entire world.  In the history of cop-outs.  Ask someone to do the impossible, but it's okay just push yourself. Here's a thing that literally can't be done... do your best.

Okay, here's two sandwich bags, a handful of oak leaves, and a measuring cup.  Build me a refrigerator.  Ganbare.

Oh well.  At least health insurance is cheap.  If there's one good thing that can be said about Japan's healthcare system (which is coincidentally the exact number of good things that there are about it), it's that it proves the old adage correct: you get what you pay for.

Before I continue, I'd like to say that the following paragraph does not apply to the surgeon who took care of my second toe surgery (he also has never said ganbare).  You, sir, actually rolled up your sleeves and did something.

So, Japanese doctors, for your terrible care, utter disregard for an entire century o fmedical science, and your worthless, one-word medical advice, I'd like to send you all a big, hearty "fuck you."  Take those scalpels to your own throats and see how far you can launch a blood-rocket.

Ganbare.

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