I know this is a game related blog, and this post isn’t game related, but this is a fun story, so what the hell…

I live in Japan. A few weeks ago, I got an ingrown toenail. I thought that it could be fixed quite easily with a quick operation as I had done a few years ago when I lived in America. But this is Japan, and nothing is that easy!

I went into a Japanese hospital to see a doctor about fixing my toe. Simple, I thought. I’ll be in and out of there in an hour. It wasn’t until my arms were being tied to the table and I was staring up at the array of blinding lights in a room full of surgeons that I started worrying that my Japanese wasn’t as good as I thought.

But that’s skipping ahead in the story. Let’s back up a bit. I’m actually quite prone to ingrown toenails. I have unusually wide nails. When the nails start cutting into the skin on the sides, I can usually just keep it clean and it heals up. But sometimes it just gets worse and eventually gets infected. Four years ago in America, I went three weeks with a deeply infected ingrown toenail, hoping that keeping it clean would make the problem go away on its own. It didn’t. I ended up finally going in to see a doctor. Here’s how the American version of the whole procedure went:

“Yup. That’s an ingrown toenail. You get these a lot? You want to have surgery so this doesn’t happen anymore? Ok, I’ll cut out the left and right edges of that nail on your right foot to make that nail a normal size.” A lone doctor in a normal examination room injected two shots of anesthetic into my toe, waited ten minutes, then came back, made two vertical cuts on the sides of my nail, pulled each edge out with pliers, put some chemical in the holes to repress the nails growth on those sides, and bandaged me up. I watched the whole thing, paid, and walked home. I took over-the-counter meds for the pain. It was quick, painless, and there were no complications. I was healed up in a week or two.

In hind-sight, I should probably have had him do the same operation on my left toe, just as a preventative measure.

Fast forward four years to the present. I live in Japan now. Okinawa, to be more precise. I teach English and have a very busy schedule, so it’s tough for me to take days off of work. Not just because of the paper work that goes along with taking even a few hours off for a doctor visit here, but because missing class means rescheduling a class and having an even busier schedule later when those classes pile up.

So, when I got an ingrown toenail (this time actually caused by a sofa-related incident) that wouldn’t go away on my left foot, I waited until Saturday to go see a doctor. After the usual lengthy waiting period, I was finally in front of a doctor. He looked at my toe and told me (in Japanese) that he was going to prescribe me some antibiotics to make the infection go away and that the wound should just heal itself in a few days. I was thinking, “Let’s do that surgery thing that I did in America so this doesn’t happen again.” But being a responsible foreigner in Japan, I didn’t want to fulfill the pushy American stereotype that they have of us. I was just going to go along with it. He told me to come back on Monday. I winced thinking about the classes that I’d have to reschedule, but agreed.

By Monday, the infection was all cleared out, but the nail was still digging into the skin and quite painful. I begrudgingly shuffled my Monday morning classes to fit in later in the week and went back to see the doctor. He pretty much just glanced at it and told me that it should slowly heal up by itself now. He then turned and asked me, very casually, “Can you come back every day this week?”

I looked at him like he was crazy. Did he really think that this was so serious that it required a daily check? Did he know how difficult it was for me to come in on weekdays? Was it worth me spending an hour in the waiting room just for him to take a few seconds’ glance at my toe and tell me to come back again? Urge to fulfill pushy American stereotype rising…

“Do you really need to see me every day?”

He replied in English. “Japanese system,” he said with a smile.

“Surgery!” I blurted out. But in Japanese, so “Ope!”

I told him I wanted to have the surgery to fix my toe. I told him that I have problems with it all the time and would like to make the nail narrower to avoid future problems. And I told him that I’d like to have the surgery today. He consulted a nurse and told me he could do it at one o’clock. That was three hours away, but I had my laptop, so I’d wait. He told me that they needed to run a blood check before the surgery. I thought that was a little odd, but whatever. Japanese system.

I called my school and told them to reschedule my afternoon classes too. I was just going to end up with a really busy rest of the week.

I followed a nurse to where they would draw some blood. Five vials of the stuff. But whatever. Japanese system. The nurse then pricked my ear and then sat there staring at me. I was a little confused until I noticed that she kept glancing at her watch. She was timing to see how fast I clotted.

I was next led to a room with a number of beds and told to change my clothes into a hospital shirt and pants. I complied and then was laid on a bed and hooked up to an IV of antibiotics. They left me alone with my drip, so I busted out my laptop and got some coding done on the game, though I was a little distracted by my neighbor, Contagie McCoughsalot. I started wondering whether or not the thin curtain between us was going to stop me from contracting an inconvenient case of death.

A while later, another nurse came in with two syringes. She injected a tiny drop from each in different parts of my arm and marked each place with a sharpie. I presume this was to test for allergies to… something. Blood check, ear prick, IV, two allergy tests… I had been stuck five times now, and hadn’t even gotten to the operation room.

Another while later, an entirely new nurse came and asked me if I had gotten “rentagen” yet. Now, my Japanese is alright, but medical terminology isn’t exactly a priority in my colloquium. Since this nurse had apparently never played charades or Taboo as child, as she was incapable of explaining things using synonyms or gestures, it took a while for me to figure out that “rentagen” meant “x-ray.” X-ray may be one of the first English words that you learn, but that’s just because it’s the only word that starts with x, not because it comes in handy during daily conversations.

I couldn’t understand why they needed an x-ray. But whatever. Japanese system. So we did that. Walking around the hospital to the x-ray room netted me plenty of odd stares from the other hospital denizens. As a six foot four inch white guy living in Japan for three years, I’m used to getting stares. But it’s a bit different when you’re a six foot four inch white guy in a three-sizes-too-small hospital gown. I guess they don’t come in “lanky.”

Finally, after a busy three hours, it was time to head up to the operation room. I proceeded, pushing my IV trolley around with me, into an airlock-like chamber, where I had to change again into clean room clothes and was even given a little cloth hat. Eventually the inner doors opened and a new set of nurses, this time all done-up surgery-style, with masks and little hats that matched mine, escorted me into the operation room.

The room was huge and sterile, with a giant array of lights on the ceiling and another on a movable arm. The table was cross shaped, and I was told to lie down with my arms out to the sides. After some giggling from the nurses as they realized that the table was too short and they had to wheel in an extension to accompany my feet, I was in place on the giant cross.

Finally the doctor came in accompanied by another surgeon. He asked me if I was ready. I was holding back laughs at how over-the-top this all was. I told him to have at it. Then they literally tied my arms to the table and set up a blind over my chest so that I couldn’t see my feet. I had no way of seeing what was going on down there.

As the nurse told me that they were going to inject the anesthetic, I was frantically running through the day in my head. Specifically, I was trying to remember what exactly I had said to the doctor when I asked for this surgery. Did he know that he was just taking a part of the nail and not the whole leg? I thought back to the numerous papers I had to sign. I couldn’t read them, but signed them anyway, thinking they were just the standard over-abundant Japanese paperwork. When the nurse was talking to me about the meaning of each page, was I paying enough attention? Was my Japanese just really flawed? Would I ever walk again?

“Doctor! Stop!”

His head poked out from behind the blind.

“You’re just taking part of the nail, right?”

“What?”

In America, it was one doctor in an examination room. Here, I had two surgeons and six nurses in a giant surgery bay that might as well have had one of those observation rooms up near the ceiling. In America, it took a few minutes and I watched as the doctor performed the cuts. Now, I’m tied to a table with no idea what’s going on below my waist! It’s supposed to be a simple operation!!! Why are they over-reacting?!?!

“There are no amputations scheduled for today, are there?” I stuttered.

“Not that I know of.” He looked confused. “Relax, this is just a simple operation.” As he saw the panicked expression on my face, he added, in English, “Japanese system.”

I laid my head back and let the operation proceed. Twenty minutes later, my hands were untied and the blind was removed. I looked down to see my intact foot, complete with unnecessarily giant bandage around the big toe.

The nurses helped me off my crucifix table and into a wheelchair, which I didn’t really need, and wheeled me out, through the airlock, back to the room with the beds. I changed back into my clothes, slipping the bandaged foot gently into my sandals, and then met the doctor back in the examination room. He asked me to come back two days later to have the bandage removed and then again a week later to have the stitch removed. I quickly agreed, not worrying one bit about my classes.

While everything had seemed so excessive and unnecessary up to and during the surgery, I could no longer think of the extra annoyances that this had caused, instead, I was thinking back to the time I had this operation in America. Was that examination room really clean enough for that procedure? Had the American doctor taken any precautions to prevent post op infection? Was he even wearing gloves?

I can’t remember the answers to those questions, but I can remember every minute of this over-the-top Japanese version of the surgery, and I understand it all now.

All those extra steps may have been unnecessary and annoying, but they were taken for my protection. They were taken to ensure the successful, complication-free completion of the procedure. And they did the job. That‘s the Japanese system. Oh, and to the Japanese system’s credit, even with all these tests, nurses, and precautions, the procedure cost about the same here as it did in America.

This entry was posted on Monday, July 9th, 2007 at 1:57 pm and is filed under Miscellany. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.