病院

It's been a slow few weeks. I've been sick for most of them with a persistent cough/cold that simply will NOT go away. Even Nyquil hardly makes a dent! My visit to the clinic resulted in stomach medication. Oh, yes. That will certainly help clear my lungs.

Doctors in Japan, and the whole medical system itself, are profoundly different from those in America. For most people in America, there is an inherent distrust of doctors. What they do is mysterious, and could result in a pair of forceps being accidentally left in our intestines for years. Doctors must constantly protect themselves from accusations of malpractice by having consent forms, explaining things thoroughly to the patient, and double or triple-checking whenever possible. Whether this is a good thing or not is hard to say. It may make the patient safer, but it also forces the doctor to waste time and effort explaining complicated concepts to people who, from lack of expertise, are unlikely to be able to make an educated decision regardless. But it's what I'm used to, and I take comfort in knowing what's going to happen to me in a hospital.

Not so in Japan. Here, patients are expected to place full, unconditional trust in their doctors. Questions aren't asked, and explanations aren't given. It is up to the doctor and the doctor alone to decide what is best for the patient, and the patient's role is simply to cooperate and put up as little fuss as possible. Japanese patients seem willing to accept that their knowledge is extremely limited, and happily defer to the more experienced doctor. I'm not sure if this respect extends itself to the nursing staff, but I imagine it would.

Many Americans, at least those not in an emergency situation, feel free to offer their own self-diagnosis to the doctor, and their own suggestions as to the proper medication and treatment. If the doctor disagrees, fights can ensue, and patients can threaten to switch clinics, which loses the doctor revenue. Though I feel that the patient's thoughts are important, it doesn't make sense to me to actually ARGUE with the doctor unless he or she is somehow completely off-base.

But in Japan, the patient doesn't get that sort of courtesy. Hence why I got stomach medicine for my cold. I'm still baffled by that one. I wasn't told what sort of medicine I would get before I had to pay for it, and I can't even really read the directions for use anyway. I wasn't asked or expected to give information to the doctor. He was to examine me and come up with his own conclusions based on what he found. Scientific, perhaps, but I'm pretty sure my stomach is just fine. Not sure what happened there.

It is still somewhat common in Japan for terminally ill patients suffering from cancer or some other disease to NOT BE TOLD their diagnoses. Many doctors seem to feel it's not worth causing the patient "mental anguish" by telling them that what they have is fatal. The patient's family will be told, but the subject himself will be left in the dark so as to live out his final days "in peace." In most cases, the patient himself doesn't want to know, either. He simply trusts that the doctor has his best interests at heart, and any withholding of information is for his own good.
I just don't get it.

The Kurosawa film "Ikiru" deals with this when its main character has stomach cancer, but isn't told so by his doctor. He gleans the truth all the same, and resolves to change his life slowly but surely in the little time he has left. He takes risks and shouts and breaks out of the dull cycle of bureaucracy he was stuck in for so long. The movie takes jabs at the medical industry, presenting the message that it's better for the patient to be informed. Then he or she can use their last moments how they see fit, instead of slowly wasting away without knowing why. I can't help but be inclined to agree.

In less serious news, hospitals in Japan are also really IV happy. Anyone who comes in, regardless of their diagnosis, is hooked up to an IV with electrolites and other stuff. The thinking seems to be that such a precaution couldn't hurt, but WHY anyone would want a useless IV is beyond me. I had to really campaign at the clinic to not get an IV stuck in my arm. If a needle isn't going to save my life, I could really do without, thanks.