On a cold winter morning at Narita airport, I was traveling home for Christmas break. As I boarded the packed plane, I quickly settled into my seat and looked out the window at the pouring rain. On that day, a typhoon was making its way into the city. After 30 minutes grew into an hour, I knew we’d be on the ground for some time. Like any person stuck on the runway, I attempted to entertain myself.
I took off my shoes (yes, I am that person), began my movie marathon, and unwrapped the food I had secretly smuggled onboard. But something was off. Different.
My chest began to tighten, my breathing became laborious.
There, in that moment, I realized that in the crinkled wrapper of my overpriced California chicken sandwich there were nuts in the pesto and I was indeed showing signs of anaphylaxis shock.
For those who don’t know, this allergic reaction can cause hives, difficulty breathing, shock and if not treated quickly it can even be fatal. With the rain letting up and a window for take-off looming, I knew that I had to act fast.
I quickly flagged the attendant and an announcement was made ‘is there a medical doctor aboard? A young woman in row…seat…’ Ugh, I swear when a large group of people just stare at you, you can feel it, and it didn’t help having to calm my flight attendant during my emergency. Even after taking medicine, a collective decision found that it was safer to unboard and await another flight. As I was escorted off, I held back tears of humiliation and frustration. I was thankful to be safe, but I hated the vulnerability that came from it.
To those who don’t have food allergies, I applaud you. You’re a rare unicorn able to frolic around without caution in this world. But for the rest of us, you know how annoying and debilitating it can be to manage. Oftentimes, it takes us to the brink of vulnerability and embarrassment. It’s terrifying. It takes time. It’s inconvenient. Happening only in that one moment when you pray to the Lord, your ancestors, Allah, or the Buddha that it wouldn’t but it does.
Fortunately, this was not my first time experiencing the Japanese healthcare system. From the mundane to the unusual, my time here has been riddled with close encounters and frequent hospital trips. While I felt prepared in this emergency situation I can’t say confidently that when I first arrived, navigating the Japanese healthcare system was easy. Put bluntly, it was overwhelming.
There are many nuances to Japanese hospitals that are very different than those in other countries. In Japan, hospitals close earlier than shopping malls while some require referrals to see their doctors. Then there are the membership cards, confusing lines, and seemingly mandatory sea of elderly people unafraid of giving you the ‘side-eye.’ These nuances can be complicated by something else: fear.
- Will I be treated as seriously as a Japanese national?
- Are there cultural differences in treatment?
- Will they actually listen to me?”
There can be a lot of concerns when considering whether or not to see a physician in Japan. And these feelings are legitimate. Yet, one way to overcome this is to rebrand it. You see, self-care isn’t just a movement to reclaim ourselves through working out, meditation, and eating right. It’s about preemptively making moves in doctor offices by using our fear to work for us. Rather than limit, we can use it to inspire ourselves to become excellent in our advocacy and experts in our health inside and out.
To help you on this journey, here are a couple tips that I’ve accumulated over the years. Feel free to scroll down or click the links to jump to the sections.
From the few impromptu ambulance rides I’ve had, two to be exact, I’ve learned one thing: always be prepared.
1) Eating – Restaurants are becoming more experimental. Know your key phrases and always ask before ordering if you’re unsure of what’s in a dish, even if it’s a stretch.
2) Stock Up – Surprisingly, it’s very hard to find an over counter equivalent to Benadryl. If you have a friend or when you’re home on holiday, stock up and I mean a lot!
3) Have On Hand – Make it a habit to carry clear and brief translations of different medical emergencies, requests, and contacts. Write them on paper, put them in your wallet, and take a photo on your phone in case of a situation where you can’t communicate.
4) Surroundings – Always be aware of where you are in relation to where you are headed. Many hospitals close around 6, so always have a back up. Look for: konbans, hotels, and stations.
5) Plan C – I’ve been in situations where station attendants refuse to help during an emergency. Long and frustrating, the short is advocating for yourself. Stay in public areas and look for a store, a restaurant, call a friend, or ask a stranger. Do everything to get the care you need.
6) Stay calm – Anxiety and adrenaline will only impair your judgement and waste time.
Health insurance isn’t just for emergencies. Use it for wellness checks ups and stay on top of your health. Whether it’s influenza, a leg injury, or dental cleaning, here are a couple of useful tips that I’ve used.
1) Appointments – Many clinics don’t have online portals, so you have to call in. Ask someone for help if you need it and listen to their conversation. Ask them later what they said, so that you can call the next time.
2) Write It Out – If your Japanese could need some work or you suffer from social anxiety, have your concerns written down before you go to your appointment.
3) Translators – Ask friends or colleagues to help. If you can’t, some major hospitals employ translators. Try to find one, or ask another doctor to write a referral to one.
4) English speaking doctors – An obvious choice for many, but a lot harder to find. Some websites promote themselves as being English-speaking, but that’s not always true. Ask when you call in.
P.S. Just because they speak English doesn’t mean they’re better trained. Although English-speaking ones are great, always prioritize references from friends and colleagues.
5) The Rapport – Look for a doctor that you can set up a long term relationship with. Someone kind, respectful, and has a good bedside manner. This will make you more comfortable for future visits.
When I was a teacher, I injured my larynx, or vocal box, and it took over a 1.5 years to find the right specialist to help. Along the way, I discovered some interesting things:
1) You might have to travel – Unfortunately, most specialists are in metropolitan areas. If that prefecture’s capital does not work, it might mean a trip to a larger city like Tokyo, Kyoto, or Osaka. No matter where you go, don’t lose hope!
2) Help From The Experts – There are many foreign medical associations in Japan with directories that can help point you in the right direction. Don’t be afraid to reach out. Feel free to email the association directly with questions. It may take a couple of unresponded emails, but eventually, they will answer.
3) Get Creative – Sometimes the diagnosis is unclear or may find that you are not getting the answers you need. In these times expand your net. Contact medical associations and be open to suggestions beyond your borders. This may mean telehealth or going to the doctor when you visit home. Please note, always be cautious when exploring telehealth. Especially in terms of payment. Some doctors take international insurance, others don’t.
1) Be Your Own Advocate – If you don’t like a diagnosis, get a 2nd and 3rd opinion. Doctors don’t know everything and you shouldn’t expect them to.
2) Study – Take a Saturday to become acquainted with common kanji on clinic sites.
3) Bedside manner is Everything – No matter where you are, how a doctor treats their patients is important. Recognize what’s acceptable behavior and what isn’t.
- They take the time to speak with you.
- They try to explain things, even if you don’t speak Japanese.
- They’re appropriately touching you with your consent.
- They speak kindly and are honest.
- They explain their procedure beforehand and their diagnosis afterward.
- They call you “the foreigner” in their conversations with nurses.
- They’re impatient and rude.
- You feel like there’s no time to talk about your concerns and ask questions.
- They don’t listen.
- You feel uncomfortable with them.
- They’re trying to sell you something.
Be patient and breathe. Finding the right doctor is like going on a dating app. It can be frustrating at times even exhausting really. However, when you finally do find the right one, you two meet and realize that you’re a true team.
The truth is there are going to be a lot of doctors that aren’t for you, and advocating for yourself every time takes work. Accept and embrace this process because finding the right one makes a world of difference and you deserve the best.