Nick and I celebrated Christmas of 2007 in a lovely Buddhist monastery on a un-toursity island near Bangkok. We traveled around Thailand with our friend Cat(herine). Then, for new year's, Nick and I took a romantic trip alone to an island called Ko Kood. In order to get to the island we were taken advantage of by a taxi driver, and then left marooned on a dock without the boat ride we'd purchased (infamous Thai 'travel agent' crooks). We begged and pleaded and insisted that they get another boat, and after a couple hours of waiting, hopped onto a little speedboat there with a few other sea-sick couples. But, oh, it was worth it! Some of the resorts on this remote island were fantastically expensive; the Russian tourists stayed there. Our 'resort' consisted of some spots to pitch tents, and some brick huts with grass roofs; perfect. The resort owners are a lovely and generous Thai family. We spent a couple days wandering around on foot before we decided to rent a small motorscooter to explore the other side of the island. Now, everyone knows that scooters aren't safe, but when you're on vacation you think "well, this is my only opportunity..."
THE ACCIDENT
Off we went, on adventure! Helmets weren't available. Bumpy, dirt roads. A crudely photocopied map written in Thai. A couple hours later, we were writhing on a wooden bridge. Some villagers ran out from the forest, put me on the back of a motorcycle, and we bumped along to the island clinic. I was in shock, watching my blood drip on the exhaust pipe. Nick, also injured, rode our rental motorcycle back to the resort for the English-speaking resort owners. There were two nurses at the clinic when I arrived. My left elbow was deeply cut with gravel in it. My left shoulder hurt. My left foot was broken and deformed and really nasty with very little skin on top. The nurses took an X-ray, looked at the image with puzzled expressions, and shrugged. I was given some very mild pain meds. Nick's left hip was deeply traumatized with a bruise that didn't fade for several months. Our friends at the resort provided saving grace as translators, cooks, and chauffers. Eventually we were sent back to the resort, but the last boat had already left the island for the day, so our option was to take the first boat in the morning to the mainland. Of course, if we were thinking clearly, we would have been life-flighted out, but we were in shock...
TRAVEL
The next morning the son of the resort owner carried me into a speedboat from the dock. Nick limped behind with our bags. Not such a romantic end to what was a lovely tour. After an excruciatingly bumpy 2 hour boat ride to the mainland, an ambulance met us at the dock and rushed us off to the hospital in Trat, Thailand. The ER docs tsk-ed and groaned as they cleaned our wounds. X-rays showed my obvious breaks. IV antibiotics pumped into my veins. We were checked into the most lovely, huge hospital room with fresh orchids on my hospital bed -- really! Jobby, the daughter of the resort owner again provided translation and emotional support. We stayed at the hospital for a couple days and then traveled back to Bangkok for our scheduled flight out of Thailand, back to Japan. Of course, if we were thinking clearly, we would have flown home to America, but we were in shock...
We were loaded onto a luxury (almost) bus for a bumpy 7-hour drive from Trat to Bangkok. Then taxis to the airport. Blessed wheelchairs at the airport. Jobby met us in Bangkok, helped us communicate with the airlines, and bid us a teary adieu. Some saintly businessman traded his front-row seats so that I could prop my cast up on the wall for the flight from Bangkok to Osaka. No, the airline didn't give me any special seats despite our injuries and protestations. Then we flew Osaka to Sapporo. Of course, if we were thinking clearly, we would have gone straight to the hospital when we arrived in Sapporo, but we were in shock....
So instead Nick bought us tickets back to Furano. The island of Hokkaido, I should clarify, is thought of like Appalachia is to the USA. And Furano is, well, in the middle of that wilderness. (Lots of bears in the woods. Not a lot of healthy teeth in the children. You get the picture.) From the Sapporo airport we got on a train into the city center. And then, shocked by the Siberian snow and icy streets, I tried to maneuver on crutches to the busstop. I was sobbing with pain. A young woman ahead of me backed up directly into my wounded leg; I freaked out and actually hit her with my crutch (not proud of that moment).
JAPANESE MEDICINE
Japanese healthcare, though internationally famous for its quality, is not all it's cracked up to be. Sure, there is more focus on preventative medicine, which is an excellent idea. And it's true that they do incorporate traditional effective medicine (herbs, acupuncture). And, of course, there is nationalized health insurance. I've already written a blog post about some of my medical care for my broken foot here. It was shit, to put it succinctly.
A couple brief notes about my understanding of Japanese medical policy, as it's been explained to me. A note about physician's medical assignments: In Hokkaido, all governmental employees like doctors and teachers and city workers are moved around from job to job every few years. It is systematic and not based on the wishes of the workers. So a doctor in Sapporo may work in a hospital for 4 years, and then be transferred to Wakkanai, and then be transferred to Furano. All around the island. S/he changes hospitals, and her/his patients get a new doc. This means that, ideally, the best docs are not in the big cities because they get moved around. But also, the docs do not have much quality of life or active commitment in the communities. Another note about medical education: I hear that Japanese doctors don't do residency to declare a specialization. Once they finish med school, they just get to say "I'm a cardiologist" or "I'm an optometrist" as their interest lies. Then they start practicing their new profession; you can imagine there is some learning curve. A note about nurses' training: Twice a month, I taught English classes at Furano's nursing college to students in their final year of school. It was shocking to me how little these students knew about healthcare. One example: in a lesson we asked the students what they should say to a patient who comes into the ER saying he has the worst headache of his life, and he's felt this pain for three days. The nurse's response? Take these pills and come back next week. Shocked, we asked the question again in both English and Japanese to make sure they understood the scenario. We clarified and discovered the nurses had not been trained on aneurysms. (My co-teacher and I subsequently vowed not to get sick in this town.)
MY MEDICAL EXPERIENCE
The nurses in Furano, charged to change my bandages every few days, were instructed to rip off the old bandages. With lack of training and supplies, they re-opened the wounds on my foot every couple days, to replace the bandages with new ones. I gave them these plastic screens to put over the wounds (I'd received the screens from the Thai hospital), to put directly on the skin before the gauze, but the undereducated doctors and nurses would not let me use the screens. So their solution was to rip me open. The wounds didn't close for six weeks.
The X-ray techs didn't have lead aprons to protect me from the many x-rays to which I was exposed. Or, when there were lead aprons available, I had to ask for them specially, and the protective aprons were literally dusted off for me.
The dermatologist who removed stones from my skin was a butcher who refused to wear rubber gloves and worked in a filthy, crowded storage room-turn-operating room. (My physician sister-in-law says the stitches look like they were done by a child.)
I did receive a CAT scan and an MRI to look at damage to my shoulder, but I'm not sure if anyone was trained to understand the pictures. After about two months complaining of shoulder pain, exacerbated by the wheelchair and crutches, I was prescribed physical therapy for my shoulder and foot. I would say that my physical therapy was the only effective treatment I received in the hospital.
Of course, once realizing that the Furano hospital would not be able to provide me with good medical care, I could have traveled to Sapporo, or better yet, just gone home to the US. But we didn't. I didn't prioritize my health. I felt compelled to finish out the year for various complex reasons, mostly to please others. I regret that decision.
My Japanese acupuncturist worked overtime on my biweekly appointments to ease out my pain. I saw him the entire year I was there, and he was perhaps the only person (other than my saintly fiance) who understood the trauma my body had experienced. He tsk-ed with empathy while pummeling my shoulders and needling my crown. He was an excellent caregiver. It's only now, two years later, that I let Reiki and acupuncturist practitioners touch my foot. So much pain and trauma is stored there.
STEPPING FORWARD
But, dear readers! Since the accident I have hiked, run, moved my household twice, practiced countless downward-dogs, performed ballet-style pilates, danced the polka, and challenged my body in many other ways. I'm scarred, but I am healing. Most adults have broken bones; others have succeeded. We are lucky to be alive. I am determined to release the inner scars and trust in my body's innate aptitude to heal and be well.
JAPANESE MEDICINE
Japanese healthcare, though internationally famous for its quality, is not all it's cracked up to be. Sure, there is more focus on preventative medicine, which is an excellent idea. And it's true that they do incorporate traditional effective medicine (herbs, acupuncture). And, of course, there is nationalized health insurance. I've already written a blog post about some of my medical care for my broken foot here. It was shit, to put it succinctly.
A couple brief notes about my understanding of Japanese medical policy, as it's been explained to me. A note about physician's medical assignments: In Hokkaido, all governmental employees like doctors and teachers and city workers are moved around from job to job every few years. It is systematic and not based on the wishes of the workers. So a doctor in Sapporo may work in a hospital for 4 years, and then be transferred to Wakkanai, and then be transferred to Furano. All around the island. S/he changes hospitals, and her/his patients get a new doc. This means that, ideally, the best docs are not in the big cities because they get moved around. But also, the docs do not have much quality of life or active commitment in the communities. Another note about medical education: I hear that Japanese doctors don't do residency to declare a specialization. Once they finish med school, they just get to say "I'm a cardiologist" or "I'm an optometrist" as their interest lies. Then they start practicing their new profession; you can imagine there is some learning curve. A note about nurses' training: Twice a month, I taught English classes at Furano's nursing college to students in their final year of school. It was shocking to me how little these students knew about healthcare. One example: in a lesson we asked the students what they should say to a patient who comes into the ER saying he has the worst headache of his life, and he's felt this pain for three days. The nurse's response? Take these pills and come back next week. Shocked, we asked the question again in both English and Japanese to make sure they understood the scenario. We clarified and discovered the nurses had not been trained on aneurysms. (My co-teacher and I subsequently vowed not to get sick in this town.)
MY MEDICAL EXPERIENCE
The nurses in Furano, charged to change my bandages every few days, were instructed to rip off the old bandages. With lack of training and supplies, they re-opened the wounds on my foot every couple days, to replace the bandages with new ones. I gave them these plastic screens to put over the wounds (I'd received the screens from the Thai hospital), to put directly on the skin before the gauze, but the undereducated doctors and nurses would not let me use the screens. So their solution was to rip me open. The wounds didn't close for six weeks.
The X-ray techs didn't have lead aprons to protect me from the many x-rays to which I was exposed. Or, when there were lead aprons available, I had to ask for them specially, and the protective aprons were literally dusted off for me.
The dermatologist who removed stones from my skin was a butcher who refused to wear rubber gloves and worked in a filthy, crowded storage room-turn-operating room. (My physician sister-in-law says the stitches look like they were done by a child.)
I did receive a CAT scan and an MRI to look at damage to my shoulder, but I'm not sure if anyone was trained to understand the pictures. After about two months complaining of shoulder pain, exacerbated by the wheelchair and crutches, I was prescribed physical therapy for my shoulder and foot. I would say that my physical therapy was the only effective treatment I received in the hospital.
Of course, once realizing that the Furano hospital would not be able to provide me with good medical care, I could have traveled to Sapporo, or better yet, just gone home to the US. But we didn't. I didn't prioritize my health. I felt compelled to finish out the year for various complex reasons, mostly to please others. I regret that decision.
My Japanese acupuncturist worked overtime on my biweekly appointments to ease out my pain. I saw him the entire year I was there, and he was perhaps the only person (other than my saintly fiance) who understood the trauma my body had experienced. He tsk-ed with empathy while pummeling my shoulders and needling my crown. He was an excellent caregiver. It's only now, two years later, that I let Reiki and acupuncturist practitioners touch my foot. So much pain and trauma is stored there.
STEPPING FORWARD
But, dear readers! Since the accident I have hiked, run, moved my household twice, practiced countless downward-dogs, performed ballet-style pilates, danced the polka, and challenged my body in many other ways. I'm scarred, but I am healing. Most adults have broken bones; others have succeeded. We are lucky to be alive. I am determined to release the inner scars and trust in my body's innate aptitude to heal and be well.
