Saturday, October 29, 2016

Medical Adventures in Japan



My first Japanese medical experience occurred after only a week in the country. My shoulder hurt and I could not lift my arm. I googled up for a few seconds (should be equivalent to four years of medical school right?) and self diagnosed having a super awesome, top athlete injury called a "ripped rotator cuff."

Obvious diagnosis for studmuffin unable to raise his arm
So I went in to the doctor, who spoke no English, and was informed, somehow, with the assistance of a useful cartoon pamphlet: "You only wish you were on the starting rotation of the Hanshin Tigers Baseball team. In fact you are an old bureaucrat. You don't have a ripped rotator cuff, you have 50 year old shoulder disease. Suck it up." At least that is what I think he said. Having disclosed my condition to my geriatrician sister-in-law she exclaimed "what? you have frozen shoulder?" and taunted me mercilessly, raising her arms above her head with a gleeful giggle, saying 'look! I can do this". This taunt is etched deeply in my memory, and will stay with me longer than this frozen shoulder (I think).

Now, let me get back to the purpose of this post: medical event number two. I got an ear infection. I get these a lot due to my 'narrow ear canal' - though I only started getting them in my thirties (why so late in life?). Anyway, all the standard symptoms. Plugged ear. Pain when pulling on lobe. Itchy. I have self diagnosed this many times and keep a half bottle of ciloxin drops that expired 3 years ago handy specifically to wipe these bothersome infections out without bothering to go the doctor for a new prescription. I have a slight fear I may be breeding some ciloxan resistant bugs in my ear... I tried my usual treatment and felt no immediate improvement. Uh oh. Either I have finally succeeded in culturing super bugs in my ear, or this medicine with an expiry date in 2012 and an instruction to "discard one month after opening" has indeed expired. OK, time for another visit to a Japanese doctor. I'll tell him the symptoms, perhaps let slip the obvious diagnosis, and he'll prescribe some new pills and drops. I hope the fool does not diagnose me with 50 year old ear disease.

So I went to the doctor. After a bit of tweaking and hemming and hawing he pulls out what I thought might be some kind of device to look into my ear, but turns out to have been the INSTRUMENT OF DEATH.

Let me digress. I was on a ship in the Antarctic for three months in 1986 and my cabin-mate developed a wart. He thought, well, we have a free doctor on board, why don't I just make use of this service and get this wart removed. Could be a nice co-benefit from spending two months on a ship, in the dark, in the Antarctic winter. The doctor had very little to do cooped up on our boat (recall: In the dark. In the Antarctic winter), and was thus, perhaps uncharacteristically (though I am not sure), excited about this wart. He applied caustic acid and pulled out a sort of medieval torture device that looks like a grapefruit spoon and started scraping my cabin-mate's wart (though left nameless, this cabin-mate is a famous scientist from Lamont Doherty / Columbia University). The doctor prescribed coming back every day for new acid applications and scrapings. He said "Ve must clean it up. it must be clean" in a heavy German accent. After a few days my cabin mate started to get pained and annoyed. He did his best to go anywhere on the small ship the doctor wasn't to avoid his scraping sessions. Germans like to purge impurities. Zis is a vell known fact.



Grapefruit Spoon (note serrated edge)

Anyway, to get back to my own story, at first I was blissfully unaware that the thing being placed in my ear was the Japanese aural equivalent of a German wart removing grapefruit spoon. I assumed he was just confirming my very precisely self-diagnosed inner ear infection, which I had taken the liberty of already informed him, in case he was one of these intellectually challenged doctors who don't read up regularly on wikipedia, is "Naiji Kansen" in Japanese.

Suddenly a rather loud sucking sound started emanating from the device and he placed a large pea of goop in the wad of Kleenex the nurse (huh? where did she materialise from?) was holding. At first this was not too bad, but after a few wad removals, i noticed these wads were not earwax at all. They were in fact giant gobs of blood. And the pain was intense. I'm usually pretty taciturn, but I started moaning. I mean, my since my Japanese is pretty rudimentary (as was his English), in order to avoid the possibility that maybe he did not know this procedure was burning a hole in my head, I should gently let him know about my pain so he could take corrective action. I moaned some more.

This photo from the web is clearly faked - there is no way this woman could possibly be smiling and gazing blandly off into space during this procedure:


Woman pretending to undergo ear-vacuuming treatment

This photo, also downloaded from the internet, shows the do it yourself product, and seems much more plausible:

Woman using a do-it-yourself ear vacuum
Escaping from this guy sitting in a chair in his office was going to be an even more difficult task than my friend had avoiding the wart-nazi on the Antarctic research ship. No wonder they were allies in World War II. The Japanese must be just as rabidly purist as the Germans! This guy was applying a bloody (literally) rototiller to my eardrum. Aaaaargh. I moaned some more just in case he had not applied google translate to my previous communication efforts. The nurse wiped another gallon of wax/blood on her tissue.

"Can you hear now?" he asked. I pondered a snarky remark about how if I was answering this question, irrespective of what I may be saying, I must be hearing him, since how else could I answer his question? but decided it would be a bit tough to formulate the irony of this statement in Japanese. Particularly given that this admittedly well meaning fellow had clearly not understood my universally clear, limbic moaning noises to indicate I would prefer he stop what he was doing. So I opted instead for a simple "hai" (yes).

"Don't touch it for a while. I have caused some bleeding. There is no infection. Just lots of wax. You are healed."

Well, other than my tinnitus (which unfortunately persists), I must admit that the kamikazi-nazi treatment appears to have worked. And, believe it or not, I walked away from this entire event with a bill of only 38 dollars. You can't leave your car for an hour in the remote parking lot of a US hospital for this price, let alone pay the astronomical bill that is sent 6 months later with some deeply incomprehensible notes about why it is not covered by your insurance. I wonder, in the US, do they employ vacuum sucking grapefruit spoon like treatments for ear infections?

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