*to Hanlon's razor: Never attribute to malice that which is adequately explained by stupidity.

Monday, 9 December 2013

Japan, your medicine's great, for 1975.

My son's ear doctor is talking possible myringotomy (tubes in eardrum for inner ear infection), but I am not excited about this: mainly general anaesthetic on a toddler.

I am perfectly happy to have had my two ears done, and kept most of my hearing, because it was the best practice at the time.  I recall my older brother mentioning almost two decades back that his son's doctor had suggested it for the son, and that since I'd read something then that it was becoming obsolete, I'd told my brother he might want a second opinion.  He got one: his boy's ears were cleared up with strong antibiotics.  My boy's just been put on stronger antibiotics for a week to see if that's sufficient.   Japan tends to use weaker antibiotics: if he'd been on stronger sooner this may not have gone as far.  Not good for his ears, but good for helping bacteria to become antibiotic resistant...

In Canada now, I doubt anyone would be suggesting myringotomy at three years old:
- doing it that early has not been shown to help language learning, and he's advanced for his age anyway, in Japanese
- recent guidelines are to wait longer before surgical intervention
- we use stronger antibiotics sooner, rather than what we did and they still do in Japan: weaker, longer

There are problems with Japanese medical culture relevant to this:
- doctors get very offended from asking for a second opinion, because of the deferral they are used to
- doctors are more often not up to date on recent technique, due both to a lack of fluency in the international language (English) and the deferral they are used to
- doctors tend to be very conservative in learning after medical school, from professors who were the same, because of the deferral they are used to
- doctors are among the most uncreative thinkers in the land, as they are the best at passing Japanese style examinations
- we use stronger antibiotics sooner, rather than what we did and they still do in Japan: weaker, longer

I am happy as a Canadian used to public health-care to use Japanese kind-of-public health-care when I need it, even though I've avoided anything serious ('knock knock'), but found Japanese medicine has done little good for things like colds, fevers and allergies.  However, don't fuck around with my kids!  Thank fuck we leave in the summer.


  1. I have heard that treatment of asthma in Japan is beyond archaic. It's on par with what I grew up with in the 80's/mid-90's. Having been raised with asthma on medi-cal, it wasn't until I was an adult with my own health insurance that I was actually able to get proper treatment for my asthma. Their idea of treatment was a rescue inhaler and trips to the ER to get emergency breathing treatments.

    It's not until now in my early 30's that I run full tilt without fear of having an attack because I have received the proper treatment and testing to know what triggers to avoid. I feel sorry for your little guy, ear probs are the pits. Hope he gets relief soon.

    1. My father had his asthma treated the old way. Of course, that was thirty to forty years ago, in my childhood. I bet Japan is as you say.

      Thanks for your comment about the boy. He'll be fine. He'll be fine either way. I'll just be more relieved to have him and the girl in Canada's healthcare system.

  2. Hi there, long time lurker, first time commenter...

    Of the three times I visited a doctor here in Japan, two times were as you described. It was actually so ridiculous that I was wondering if I was in fact seeing a doctor, or if this guy was just some dude who bought his title from overseas and set up shop.
    One other time I went for strep throat and got a strong antibiotics (and five other varieties of pills without any explanation as to their purpose which I never touched).

    But my general question as a long time reader of the blog is: How do you cope with this? It is very clear that you've seen beyond the "lid" and have a pretty good idea of the depth of the abyss that lurks behind Japan's surface. I've completely lost my ability to trust any local here, including doctors, to say the truth or do their job right. I often think "what if I have to go to a hospital in this country?" - I'd rather have myself flown out at any cost than to submit myself to these intricate systems of honour that stand in the way of modernity and progress.
    The Japanese don't know what they're missing, so they're fine with it. But if you come from a Western society and "know what's up", it is impossible to un-see the abyss.
    Do you plan to stay here? If so, how do you balance out what you appear to be in full knowledge of?

    1. They are not entirely incompetent, but yes, tend to be a bit more incompetent or cavalier. In truth, the life expectancy is longer here than anywhere else, so the care can't be so bad. Emergency care is fine, though ambulance care is a macabre joke requiring another post or ten. Treatment for chronic conditions is well out of date, and what I have seen for orthopedics lately in Japan I have not seen in Canada for forty years. I would not be here if I had a chronic condition much worse than my allergies, or have kept my kids here with one. On the other hand, they fixed their dentistry: when I was here in the 90s you really had to look a date in the mouth to see if you'd stick a tongue anywhere near it.

      There are fine young English speaking doctors, but hard to find and not all on the public system. You should find a doctor and hospital to use in case of emergency or regular illness long before you need them. Ask every long term resident you know for information and referrals. This link may help: http://www.himawari.metro.tokyo.jp/qq/qq13enmnlt.asp

      Good luck.

    2. Your drugs:
      - antibiotic
      - antihistamine?
      - decongestant?
      - anti-nausea (for the other drugs)?
      - analgesic?

      Yes, they make their money off prescriptions. On the other hand, most are too fucking weak to do much for/against a red-blooded Anglo.