Health and Efficiency

It’s not all doom and gloom being part of the Japanese machine; health insurance is pretty good and companies, by law, must organize yearly check-ups. For this alone there are countless specialty clinics that deal specifically with the queues of salarymen sent out to see how decrepit they have become over the year. These checks are usually pretty rigorous and give a pretty good status indication of your body. And though they are sometimes scheduled in busy periods and they can be a little bit of a chore I always follow them uncomplainingly as you really can’t mess about when it comes to health.

Today, the first day at work this year, I was greeted by a fat envelope on my desk containing all the necessary information for my check-up next week. A little guide of how to get to the clinic, an appointment sheet, a questionnaire asking the usual “do you have an illness?” or “do you smoke?” and a little DIY feces collection kit. The latter consists of a flushable paper sheet which is to catch my movements, a little eye-lash brush type affair to pick up the aforementioned evacuation and a thankfully airtight plastic vial to store it in. A lot of fun, as you can imagine. Also in preparation I must not eat a thing for roughly 12 hours before the appointment.

I can expect the usual. Apart from the feces I will also have to provide a urine sample, probably on the day. Then they’ll cart me off to a desk where a kind nurse will pierce my vein for a drop of blood. They are very good with this: always clean needles and in my many check-ups so far they’ve never missed. After that I’ll probably have a chest X-ray while the nurses hide in a reinforced, lead-lined control booth. I must remember to wear a T-shirt that day as buttoned clothing will have to be removed. Or I may be asked to strip off completely and walk around in the Japanese equivalent of clinical pajamas.

Following there may be a check, I’m not quite sure of what, where they attach some clips to my leg and arms and send some Volts through me; it is totally painless and takes about 1 second. It may check my heart or something, I’m not sure. An eye test is also on the books; a little tabletop game where you peer into a machine which shows U shapes in various orientations and of decreasing sizes and you must waggle a joystick in the direction of the open end of the U. I wish they had a score counter on this; the competitive games-player in me always takes over at this point and I try my damnest to play it well.
A hearing test next; put on some headphones and press a button when you hear a beep. And finally a weight/height check. At some clinics you will be escorted to see a doctor who may talk you through the results, or you will be asked if you desire to speak to a doctor or not.
A few weeks later your company’s administration will dump a sealed envelope with the results on your desk, all your organs and functions graded E to A and comments where necessary.

Judging by the two hour slot I have been allocated I’m getting the quick test. I’m not quite sure what the criteria are but you may sometimes get the “full test” which can take the whole morning. I had one on my 30th, so it may be just for some benchmark age brackets. The tests are the same but with two extra activities. You may get an echo-scan of your gut, a humiliating process where a nurse rubs a gelled-up camera over your guts. And possibly the Barium Shake. This is legendary and veterans always tease the newbies about how unpleasant it is. This had me very nervous but it really isn’t such a big deal. You are given a Barium milkshake to drink. This is quite heavy and not unlike trying to drink liquid brick. It doesn’t really taste of anything so the best thing to do is open your throat and let the gooey stuff slide in as quickly as possible. It is usually preceeded by the much more unpleasant chalky stomach medicine.
Once imbibed, you are ushered into a small room with a massive metal table, not unlike the thing James Bond was strapped on before the red laser made its way up to his privates. A nurse will hide in a control booth and bark orders at you through a speaker: on your left side, on your back, on your right side, on your stomach. All the while the table tilts and twists around. At some point a mechanical arm may come out to prod you in your stomach. A camera takes photos of all the barium in your system and thus provides a good view of the shape and state of, I believe, your actual stomach.
Afterwards you are given some laxatives to help move the Barium outwards, as some people get awfully clogged up with it. Indeed, it will lie heavy on your stomach for the rest of the day.
The best thing about the full check-up is that often you get given luncheon vouchers to use at a nearby café or restaurant; a little present for “fasting” for a few hours and walking around with a brick of Barium plugging your exit.

I’ve heard people, including Japanese, complain about doctors in Japan; they lay down laws, don’t encourage questions, the opposite in fact, and sometimes one can put serious doubts over their competency. There are good doctors out there, but you’ll have to shop around. When it comes to yearly health checks, though, there isn’t really much that can go wrong, especially when it’s so institutionalized. They just check the status of your organs; very little can go wrong there. It is aimed at the Japanese though, so during an earlier check, back in my podgy days, I was deemed too heavy for a Japanese person a little shorter than me; their graphs didn’t quite reach as high as my crown. Other than that it’s all pretty useful.

Also answering the “do you smoke?” question with a “yes” may possibly qualify you automatically for a lower grade for your lungs at certain clinics. I told a doctor this once during a later check-up and he checked my chest X-rays again, listened to me breathe and just shrugged it off. “Your lungs are fine!” he said. “But I smoke, admittedly very light cigarettes, about a pack and a half a day!” He looked over my X-rays again. “It’s absolutely fine,” he said. Doubtful but good news, of course.

Though the forms and questionnaires are usually only in Japanese these can be filled in beforehand so you can ask a colleague, girlfriend or wife you help you with that. During the checks themselves some very basic Japanese would be useful but you could bluff your way through it without. As long as you can handle “go here”, “go there now”, “hold this” commands you should be fine.

As a hypochondriac I am always a little nervous before these check-ups, but afterwards I always feel relieved. My results are pretty much always good and it’s very heartening to know these check-ups occur every year. That is good going, and it’s one of the better aspects of working in Japan. If you get bad grades for something you know you’ll have a year to work on it before the next check-up, and often you get given booklets with advice. Don’t eat too much bad food, don’t lie in front of the telly too much, you fat pig, that kind of stuff. They take it all quite seriously here and this is definitely one tradition am very happy to follow in.

I just hope I’ll be over this blasted snotty, throat-rasping cold by next week.


  1. Barium Shake = no big deal

    Barium Enema = Hell on earth

  2. Any Salaryman illnesses that happen to desk jockeys often?

  3. Yes, the common cold. With the Japanese refusal to stay home with a cold anyone who commutes, works with others or simply breathes air in Tokyo will share any cold bugs that happen to exist at any given time.