My Life in Tokyo

Sometimes days, even weeks go by in which I have trouble finding anything to write about. Every day brings something new and notable about living in Japan, but what do I choose? What do I write about? And what about those periods in which everything seems just boring and dull, just ordinary everyday life? What do I write then?

The past few weeks have been busy and tiring, filled with ordinary struggles of everyday life. Illness and taxes.

First, the illness. Mark’s.

On a business trip to Hong Kong at the beginning of January, he came down with a bad cold which quickly turned into laryngitis. A few days before he returned to Japan, his lower right leg started to swell up. By the time he got home, he had lost his voice completely and his leg was red and puffy. He went to work anyway, but by the next day his leg was hurting and he decided to go see a doctor. The doctor at our nearby clinic thought he should go to the hospital, so we ended up in the emergency room on a Friday evening.

I was struck by several differences between this hospital and the ones we’ve visited in New York. First of all, the main entrance to the hospital was closed at 5:00 pm. By the time I joined Mark at 6:30, it seemed totally dead. The hallways were dark and I had to enter through the single small emergency door. And then there was no drama at all. No bleeding injuries, no ambulance arrivals, no drug addicts. Just a few tired-looking people sitting in nice, clean rows of padded straight-backed chairs.

The first several visits to the hospital were frustrating and discouraging. There was a lot of back and forth between doctors, more visits to the clinic and to the hospital, and prescriptions for antibiotics and pain relievers. The clinic doctor thought it might be deep vein thrombosis or an infection, the doctor at the hospital thought it might be gout but gave him antibiotics anyway. Still, the redness began to spread above his knee and he was getting increasingly worried.

Finally, a week later and again on a Friday, I joined him at the hospital after yet another unsatisfying visit with the doctor on call. This one had told him to take more of the same antibiotics and go home and rest, with instructions to come back and see a specialist 6 days later. With the infection spreading northward, we didn’t much like those instructions. So I decided to be a pushy American and I called the clinic to enlist their help. They were initially hesitant because the doctor who had seen Mark the day before wasn’t there that day, but soon agreed to have another doctor call and speak to the one who had just examined Mark. It turned out she was able to speak directly to the infectious disease specialist at the hospital who agreed to see Mark that same afternoon.

What followed was one of those astonishing only-in-Japan episodes. We walked back over to the walk-in clinic, where we had been told to go and make an appointment. The nurse met us in the hallway and asked, “Green-san?” (pretty obvious who the non-Japanese people are!) It was 11:30 am and she told us that the doctor could see Mark after 1:00 pm, so we should have lunch and come back then. We assumed we’d have to wait an hour or two after our return to see the doctor. Mark saw her at 1:05.

Here’s what she said, and what seems most likely:

The infection is most likely caused by streptococcus bacteria, probably from the sore throat. The initial dosage of antibiotics they gave him was the Japanese dose, and since he is so tall (!) and weighs more than 60 kilos (132 pounds) (!), they should have given him DOUBLE that dosage. She recommended treating it with intravenous antibiotics for several days.

Mark returned to the hospital every day for 8 days to get his IV. The doctor popped in to see him on several visits. He was impressed with how thoughtful, patient and attentive she was. And we were both humbled by her continued apologies for her poor English—which was, of course excellent—since we are both incapable of even basic communication in the language of our host country!

Many people I spoke to about this drama gave me dire warnings about the poor state of medical care in Japan. They offered up their favorite specialists or suggested we consider going abroad. In the end, though, I think that Mark got better care here than he would have in the U.S. After the initial confusion, he certainly got more attention. And the cost of the visits to the hospital were shockingly low: one day he saw two separate doctors and had the IV administered, and the total bill was about $60. That’s the total bill, without Japanese health insurance. That’s the amount we’ll submit to our insurance company for payment. Clearly, we’ve got something really wrong with our system.

And the taxes?

Well, that’s what I got to tend to as soon as Mark was back on his feet. Round One of the big, ugly task of filing taxes for two separate countries. Yes, we do have an accountant to help us. But that never seems to be much of a help for me, as you still have to track down all the relevant data and put it in order. The first part involved figuring out the sum total of all the money that we transferred into Japan from foreign sources. Sounds simple enough, until you realize that this includes items paid for in Japan from a credit card that was paid for out of a non-Japanese bank account. And this is how we pay for a large portion of our expenses here. Fortunately, I had remembered this part from last year. And so I had been pretty vigilant about separating our Yen and U.S. Dollar charges on separate credit cards. And I have all of that data conveniently stored in Quicken. But then I read on to the part where it asked for the total in yen. And all my data was in dollars. And the exchange rate dropped rather dramatically during the year. Good grief.

Thank goodness for Excel and for all my years of experience with historical rate tables and lookup functions!