Why I Hate Hospitals

I've never liked doctors or hospitals. Usually, I equate them with needles, and as a military brat who traveled to foreign countries, I saw more than my share of needles. However, life in Japan gave me an all new reason to hate hospitals.

Japan uses socialized medicine and national health insurance funded partly by Japanese employers. In their system, there's no real appointments: You go to the hospital and fill out a card, describe your problem to the receptionist ("Kaze hikimashita" for a cold or "___ ga itai" for aches and pains. The receptionist pigeonholes you into a department (Gaika, for example, for problems with extremities), where you sit and wait until the receptionist there calls your name. You then go into a curtained area and wait for the doctor to call you, and then explain your problem to him (in Japanese). After that, you take whatever tests he prescribes (usually a urine sample and the ubiquitous blood test), see him again for the Verdict, then go to the prescription window to get nine different kinds of drugs (invariably, no matter what's wrong with you) and to pay a small fee. The wait usually is about an hour, and because of the convenience, most Japanese will go to the hospital at the slightest sign of a sniffle. I've seen old folks there who fashion their social lives around the hospital waiting room. Because of this, I suspect that 90% of the creeping crud going around Japan is perpetuated in hospital waiting rooms. So usually, I didn't visit there unless, in typical American fashion, I felt on the verge of death.

The first nightmare: I learned all about how inpatient stays worked in Japan when one of my roommates fell ill months after I moved to Japan. She collapsed in the shower. I learned a lot of Japanese that day, the first being, "Kyuukyuusha wo yonde kudasai," or "Please call an ambulance," which I directed at our next door neighbor. In the eighties, Japanese ambulances were little more than meat wagons designed to delay the unlucky patient in traffic on the way to the hospital. The drivers weren't trained to do much more than administer oxygen. They put my roommate on a stretcher and then into the meat wagon, while my neighbors and I followed in their car. In the hospital, while my friend thrashed on a table, I learned to fill out forms and speak more Japanese. Trial by fire.

Unfortunately, our well-meaning neighbors assumed we were rich foreigners and had the ambulance take my roommate to an expensive private hospital with an English-speaking doctor. "Expensive" and "private" don't necessarily mean, "quality care" because, in short, they removed her appendix when she really had kidney stones.

Basics to pack for a hospital stay in Japan: (Source: Japan Health Handbook) Pajamas Robe Towels Tea or coffee cup Glass Cutlery and chopsticks Kleenex Wash bowl Toiletries (shampoo, soap, toothbrush, toothpaste, etc.) Slippers

She went into immediate surgery, then was placed in a bed in a cold, dark, grey ward for what was to be six weeks. I've seen friendlier prison cells. The floors were brushed concrete, the single window opened onto a brick wall, and there was no nurse. We had to supply all the patient's dishes, clothing and supplies, and we had to be there to help her wash and visit the toilet. A woman in the next bed spent her days crying. In addition to helping with care, since my other roommate and I taught for the same company, we had to cover the sick roommate's missed classes as well. If it hadn't been for another close friend and her help, we wouldn't have been able to handle things.

In short, my roommate discharged herself after a week, no longer able to stand conditions inside the private hospital. She spent a week at home, then went back to work, and had another attack. This time, she insisted on going to a city hospital in Setagaya, and this time, she got the right treatment. But still, this place was daunting. Constructed during World War I, the place hadn't changed much. Nobody had replaced the ceiling tiles since that time, at least, and the walls in the common areas were darkened by years of cigarette smoke and Tokyo's ever-present grunge. One night, some time near midnight, my roommate called home for a little distraction, and in the course of our conversation, she stopped, then said in a rush, "Quick, tell me a joke--I just bumped into a dead guy."

This particular hospital was the final stop between a local senior care facility and the morgue. Every night, at a late hour so not to disturb the other patients, the staff made the rounds and picked up those who had expired during the day. One of these had been waiting at the elevator, and my roommate sort of backed into him in the dark and empty common room.

This story has a postscript: A week after my roommate's discharge from the hospital, we walked back to the hospital together: she for a followup exam; I for severe pains in my left ankle. She departed with a clean bill of health. I left on crutches, with a cast up to my knee and a bag full of drugs. The ankle wasn't broken, or if it was, the doctors were too enamored with staring at big gaijin ankle bones to notice a hairline fracture (always knew I was big-boned--the doctor's obvious shock at seeing a thick, white image on the films confirmed it). As a matter of fact, I still don't know what went wrong, but after seeing my friend's experience, I wasn't about to let anyone poke needles into the ankle, keep me in the hospital for microwave treatments or do exploratory surgery, which was what the doctor wanted to do.

The cast lasted a week. My job involved a lot of walking, and working a teaching job on crutches, with a bag of books in the middle of August was more difficult than simply dealing with the pain. Japan does not offer much by way of facilities for the disabled, other than the blind--very few elevators or escalators in the more distant Japan Railway stations. And try using crutches in a Japanese apartment where you're not supposed to have shoes and other dirty things that have been on the street. The prescribed drugs made me an emotional wreck. Finally, I flushed the pills and powder, ripped the cast off, and kept the ankle bound in ace bandages. To this day, I walk with a limp.

"Gan kamoshirenai": The one word that terrified me above all others was gan, or cancer--the leading killer of Japanese in the early nineties. According to the media, a cancer sentence instantly meant getting parts of your body hacked off, losing your hair through chemo and radiation, and counting your days to a slow, agonizing death. So when I went to a local hospital in Chiba with a general malaise and a lump on the side of my neck, that was my chief concern. The technician poked and prodded me on the table and said, "Hmm, your liver is a bit swollen."

"I've been going to a lot of New Year's parties," I told him.

"Ah, I see."

"What about this lump on my neck?"

To this day, his words are permanently etched into my brain: "Maybe it's cancer. We should do some more tests."

After he peeled me off the ceiling, he sent me home with a testing appointment scheduled. I went to work (then at an advertising agency), and was so upset that my boss demanded to know what was wrong. When I told him, he sent me to another clinic, this time a private "international" clinic across from Tokyo Tower.

The doctor I saw there had a diploma from some Navy medical school on his wall and a tendency to yell everything he said in English: "DO YOU HAVE A COLD? A COUGH? A FEVER?"

"I have a lump in my neck. Is it cancer?"

He poked the lump. "IT'S SMOOTH. TUMORS ARE USUALLY LUMPY."

"Okay, then what is it?"

"YOU HAVE A COLD? A COUGH? A FEVER...?"

After the usual blood test (what is it with Japanese hospitals and blood tests? You get one almost every time), he sent me home with a prescription for cold medicine, a €36,000 bill, and still no clue what the lump was. This is not comforting, as I'd been told that doctors often won't tell those patients diagnosed with terminal illnesses so as not to incur expensive, futile treatment or upset the family.

A friend of mine had recently gone through surgery at a new women's hospital in downtown Tokyo: Kyoundo Byoin. When I went to visit her, I found shiny new facilities, efficient staff and smiling patients. I decided to go there next. By this time, I was good and upset over this mystery lump, so when the doctor greeted me with, "Doo shimashita ka?" My struggling explanation in Japanese brought me close to tears.

When I finished, the doctor looked me straight in the eye, and said in perfect, polished English, "I don't think you have anything to worry about."

If anything justified homicide.... But then he explained that the lump was a swollen lymph node, typical of a cold, and the blood tests showed nothing out of the ordinary. Okay, so why had I needed to see three different doctors to find this out? But at last I had found a hospital I trusted.