Your Mother was Right, Always Wear Clean Underwear...

...and shave, you never know when you're going to end up in a foreign hospital in the middle of the night.

Now before we go any further, everyone's alright. There is a happy ending to this story. However, let's just say I was inspired to talk about the difference between the Japanese and Canadian health care system due to a recent experience.

On a cold and damp December night in Osaka, Carl and I were settled down to an evening of junk food and B-movies. We were watching Open Water, a low-budget film that sort of reminded us of our honeymoon and each other, without the fighting and the terrifying stranding in the middle of the shark-infested ocean. At one point, I commented, "Hmmm...where'd this earache come from. I think I'm getting an ear infection." Ten minutes later, I thought, my throat is kind of scratchy. Ten minutes after that I casually commented, "My throat is closing up kind of fast."

Now by this point it was early morning and we were well immersed in the tragic tale of love and loss on the screen. Carl was suddenly finding it hard to focus and we were starting to brainstorm solutions to this kinda scary situation. There was no need to panic, I wasn't having trouble breathing, but my throat was swelling at a steadily alarming rate. We didn't want to call an ambulance, like I said there was no need to panic, but we did think I should see a doctor sooner rather than later. We started making phone calls; to work (the only night no one's there), our health insurance office (apparently 24 hours in Tokyo is less than 24 hours in Osaka), even the Canadian consulate (the numbers cannot be reached by cell phone and we don't have a land line). So we started walking. There had to be someone close by we could talk to. Down the block to the nearby retirement home, they couldn't help me, (I'm not that old yet!) but they did give us another number to call that went nowhere. Sigh. Down another block to another hospital, they were closed with no hours posted. Double sigh.

At this point, I should tell you that Japan does have a national health plan but private healthcare facilities (the hospital we ended up at is owned by the power company). I think this might have been affecting our ability to find open doors. As it was we went back home at 2:30am to reconsider our options. We finally decided to head the other direction to the nearby police box. We knew they were open. After all, if the police couldn't help us, who could?

We walked into the tiny smoke-filled room and told them that my throat was tight and I needed a doctor (in broken Japanese with lots of pointing of course). They got some information from me and started making calls. This was when I started learning Japanese swear words. As the policeman made phone call after phone call, and then pulled out the phone book and kept making phone calls, more and more of them ended with the phone slamming and the word "Baka!" spat out in disgust. That means idiot for all of you wanting to use that at home. This went on for over 30 minutes. Sometimes a few questions were asked before the phone was slammed. But as I was not dying, did not speak Japanese and am not a child my options remained limited. Finally the police gave up and called the ambulance, that's 1-1-9 here for anyone interested.

As I hovered somewhere between exhaustion and screaming frustration the ambulance came. At a leisurely pace the nonchalant attendants loaded me into the back of the bus, after I'd removed my shoes of course. Then they hooked me up to some equipment, took the temperature of my armpit, asked me more questions, but didn't really listen to the answers, and finally decided on a place to take me. The only time I managed to peak their interest was when my heart monitor started going wonky. Having a benign heart murmur can be fun at times. They were exceedingly casual as I obviously wasn't an emergency and, being free, ambulances get abused a lot. Sometimes people use them as a free taxi service to visit friends at the hospital.

We got to the hospital and walked into a dark and deserted waiting room. We went to a hospital without an emergency room, but with a night shift doctor who spoke English. As I sat down in the exam room they took the temperature of my armpit again with a thermometer that had seen better days, and then pulled out the tongue depressor to look at my throat. He also pulled out a small yellow camping flashlight. I thought he was going to start telling ghost stories for a minute but he used it to look down my almost fully closed throat. When I started choking on the tongue depressor he told me to relax, and if I could have talked I might have said something about getting a better light so he could ... nevermind.

He then told me that he was a GP, there was nothing he could do, I had to wait for a throat specialist. Then he gave me one Benydryl. At this point I should mention that most doctors in Japan are specialists and if you have a problem you go to the doctor with that specialty, not your neighbourhood GP. And of course the specialists didn't arrive until 8am. Sigh.

By this time it was 6:00am and I'm thinking, I could have, I SHOULD have, just stayed home. I have way better drugs there and a much more comfortable couch to wait on. But we had come this far. And we didn't even know where here was, or how far we were from home. So we waited in the plastic chairs in the deserted waiting room and watched insomniac patients make their rounds of the hospital. When I tried to speak, I choked and sounded like Marlee Maitlin. Carl was alternating between uncomfortable snoozing positions and worrying over me. What were we doing here?

After a while some older women walked in and sat down, obviously waiting for the hospital to open. We had been told to wait until the front desk opened at 8. But at 7:30 there was a sudden line-up in front of two machines that spit out little bits of paper. But we waited like good little patients until just before 8 when one of the attendants gave us a little bit of paper and told us to go upstairs at 8. We weren't sure how this would conflict with our earlier instructions but at 8 someone came downstairs and called us upstairs, so we went.

I quickly got in to see the doctor. He also spoke English and asked all the usual questions. Then he gave some nasal spray and held up a machine and said "I have to look at your deep throat." I opened my mouth obediently (OK, you reading this blog - the one in the corner. Yeah you. Go wash your brain out with soap right now! You know who you are!). But he shook his head, the tube was going down my nose. He then told me that my throat was almost completely closed and that I had acute laryngitis. Huh. So that's what it's called when choke on your own throat tissue. At least that's what I might have said if I could have talked. My vocal abilities were nil at this point.

Things started to move fairly fast then. I was admitted to the hospital and given a private room and an IV. I was whisked around the hospital by a lovely nurse with no English, but who was clinging bravely to a medical book with English subtitles, as I went from exam room to exam room. I was grateful that I'd just shaved my legs as I went from x-ray to EKG to blood test and back again trying to undress and dress around my IV bag. Why did I need x-rays and an EKG for a throat infection? Who knows, I couldn't ask. Finally they told me that they wanted to keep me overnight, possibly for many days while I got better. By this time the meds in my IV had kicked in and I could croak in the voice of a tracheotomy patient, "Days?" I could stay for one night, Carl had already called in sick for me, but days? For laryngitis? I resolved to fight this injustice - later. After I'd slept. Carl and I had been up since before work the previous day, and Carl still had to work that night. It was just past noon. I sent Carl home to get some sleep. We got some giggles from the nurses when we kissed goodbye, then I went back to my room.

I promptly faded in and out of consciousness from a combination of exhaustion and the fun antibiotics and anti-histamines that were pumping into me. I was interrupted by lunch, a doctor wanting to practice English, my doctor, the administrator of the hospital (I was only the third foreign overnight patient that the hospital had ever had, kind of a celebrity) and the nurses every now and then. Carl came back after visiting hours to give me a much welcome change of clothes and pajamas and other overnight essentials. I later learned that chopsticks would have been a good idea as patients have to bring their own utensils to eat with. Luckily there was a small stock of plastic utensils for me to use.

One good night's sleep later and I was myself again. Using my newly returned, but just as unable to communicate voice, I slowly laboured over the answers to the same questions. Yes, I feel fine. No, my throat doesn't hurt. Yes, I understand you but I don't know how to make you understand that I understand you. After I convinced my doctor there was no need to keep a healthy patient in the hospital (there was also no need to keep a laryngitis patient in the hospital, but private hospitals have to make money somehow) I received my walking papers. Well, they brought me a week worth of meds and stuck that tube down my nose again, and then they sent me to the front desk to be billed. Yikes! Maybe I should have stayed in the hospital. Wait, then the bill would have been higher. Ignore my circular illogic.

We're on travel insurance. If we were on the national health plan, all of this would have been covered, with maybe a small co-pay on the drugs. However, with our work-sponsored travel insurance we had to pay upfront. Luckily we'd gotten paid the night before or I might have had to work in the hospital kitchen to get out. Over 2 weeks salary, gone.

Again, there is a happy ending. We were fully reimbursed from our insurance company two weeks later. Everyone had a Merry Christmas and Happy New Year and I can still speak and sing. Speaking of which I have recently done so in a recording studio, for a 'soon to be for sale across Japan' CD ... but that's for another blog.