An apple a day

If you live in Japan you must get yourself some health insurance. If you have health insurance you must get a yearly medical check-up. This works really well, if you ask me. I think in total I've been on all of two orso random medical examinations in my life before Japan, but since the move I've had about half a dozen of varying intensities.

The system is pretty rote, like a medical conveyor-belt. You get your forms and rules. No eating after such o'clock, no fags or booze so many hours before, no nothing, etc. Fill in your forms; "have you got any of these diseases?" or "how much do you drink?" You'll either get a vial to collect your morning urine in or even a paper net and vial-secured comb for fecal matter, though the former is often collected au naturelle at the clinic itself and the latter is usually only for the plus alpha checks.

There are two types of examination. The regular and, what I have termed above, the plus alpha. The former is most common but after you reach the tender age of 30 and every so many years thereafter with increasing regularity you'll get the plus alpha treatment. The regular check involves your urine, a finger-full of blood, blood pressure, eyesight and hearing, height and weight, probably a doctor's consultation, if you must, an X-Ray of the chest and one of those things where they check, I don't quite know, your wiring; they put plastic braces on your ankles and wrists and a set of rubber suction cups on your chests and then stare intensely at a monitor until they tell you to get up and move along. For the plus alpha you may receive an echo-scan of the guts, where you get a gelled scanner massage on your belly as if you were pregnant and most odious of all, as the Japanese say in hushed tones, the dreaded "Barium drink". This involves drinking some horribly chalky stomach medicine, followed by a Barium milkshake, a semi-tasteless, milky drink that is thick and heavy. You can pretty much feel it drop to your stomach. You're then put on a revolving table, pretty much like Goldfinger's, and shook around. You'll be asked to turn this way and that as the table does its fairground ride, all the while photos are being taken of the Barium as it sloshes about your body. Once a little robot arm even came out and prodded me just to get the Barium flowing. It's exhausting, time consuming and gives you that heavy feeling for the rest of the day. You'll be given a laxative to ingest should you be unable to pass the Barium naturally, but with the weight of gravity it is usually no real problem.

At these times my Japanese ability really gets a beating. Obviously medical terms are not used in daily conversation and are unlikely to pop up during your study or cigarette breaks. Who knows the Japanese for "blood pressure" for example? Though I suppose, as a game developer, that one would be handy to memorise.

This year the preliminary results on the day, ahead of the full report to be sent a few weeks hence, was not so much positive as unremarkable. As I am a prolific smoker, legendary drinker and consummate hypochondriac I trust these results not one bit. By now some horrible disease must have manifested itself yet of all the check-ups only once did I get a dangerously low score for my lungs. In retrospect it was probably a clinic-wide mandate to lower the score for anyone who ticks the "smoker" box on the initial questionnaire because during the doctor's consultation I mentioned it. He had a listen to my lungs with his ice-cold stethoscope, told me to breathe deeply and simply shook his head saying it was fine. When I first came to Japan and was still carrying around a little too much Western midriff, the weight/height nurse had trouble finding me on the graph. Her final opinion was then that I'd be too heavy if I had been a Japanese person of slightly smaller stature. All she needed to do was prod me in the gut to find out I needed to lose weight, which I did when I removed the daily intake of beer from my diet and replaced it with carbonated water...and wine. I'd still like to lose some, but hell, I'd like a solid gold Rolls Royce too. Never going to happen.

Though I have a slight, possibly racist, distrust of Japanese doctors and I don't quite believe the perennial all-clear reports of my obviously ailing body, it is a good system and should, if it works, be able to pinpoint problems before they get out of hand. That said, having to survive a whole morning without so much a drop of caffeine or a puff of nicotine was the most disastrous Hell I’ve ever been through and I’m very glad I won’t be having to do that again for another year.


  1. Glad to know the worst of your medical woes was the morning before. Your continued physical health contributes to my continued mental health!

  2. I had very bad experiences with the Japanese health system. Maybe I just had bad luck but I had never experienced such systemic problems in my life. In fact the worst thing I'd had happen before I went to Japan was a doctor not fully explaining that outpatient surgery didn't mean I was just going to sit on his bench while he did some light work and put a bandage over it.

    In Japan I had some quack tell me I had hepatitis. Fortunately my company's personal department didn't trust the doctor either and got me a new one.

    In Japan I got a rash, went to the doctor and he just said "sorry, I don't know what that is". He didn't refer me to anyone.

    I got massively different treatment at each hospital I visited. One hospital the doctor was sticking an endoscope down everyone's throat regardless of what they had.

    My first local doctor's office, the equipment looked like someone had coughed all over it and it had not been cleaned in years.

    I went to one hospital and had to wait 2.5 hours to see the doctor. I could be that happens other places but that was a first for me.

    I also paid the most I've ever paid for medical insurance. If have a job and they take care of it then most modern countries are probably similar but in Japan if you are unemployed or between jobs you have to pay your own insurance. Mine was $300 a month and that was for national insurance which only covers 70% of your bills.

    Then, on top of that, is the common practice that you have something serious you have to bribe the doctors in Japan a couple thousand dollars if you want someone competent.

    My impression is that it takes much much less to be a doctor in Japan than it does for example in the states and there are far less standards of medical practice. Those two issues bring it down. If you are lucky and happen to find a good doctor you win. But it's very easy to run into people labeled as doctors that would never have been licensed to practice in other systems.

  3. Cheers, dne, I wish I had some mental health. :)

    Gman, that sounds nasty. I've been fortunate to not yet have been in need of serious medical attention in Japan, so all my distrust is based on anecdotal evidence, like yours, of which there is a LOT. I would probably agree with your theory of lower entry standards. It may be like studying English: if you can memorise enough to pass the test you'll pass, whether you truly understand or can use the subject in real life or not. Scary stuff.

  4. I'm not sure if you were joking or not, but that thing with the braces is actually an EEG, where they check if your heartbeat is making sense.

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