Japanese Healthcare Redux, the ER

May 13, 2010

In case you are wondering why I haven’t posted anything in Mysterious Orientations for a few days, it is because I have been spending a leisurely time in the caring hands of the Japanese healthcare system, specifically the Horinouchi Hospital of Saitama. It seems that some poisonous insect took an intense disliking to the outside of my left knee, and chose that moment go out in a blaze of glory. At least I hope he was one of those insects that bites the dust after he bites the knee, but I don’t really know, as I didn’t see the little charmer. All I knew at first was that my knee was painful, in the sort of way it might be if I had to play catcher for three innings at the company softball game. Also, there was a tiny weeping puncture mark just to the left of the kneecap.

By day two it had gotten worse: my leg was pink (like an annoying, but by no means dangerous, sunburn) from the knee to about halfway down the calf, and somewhat swollen as well. It hurt, too, with the intensity of what used to be known as an Excedrin Headache. I thought it might be time to visit a doctor, so I asked a Japanese-speaking friend if she would help (which, to be fair, basically meant her doing the whole thing) set up an appointment with a general or family practitioner the following day. “A what?” I explained the system of a family physician in the US, a “gatekeeper” who, if he or she is unable to treat you, refers you to the appropriate specialist. “Why not just go to the specialist?” my friend asked. But what if you don’t know what is wrong with you? Well, it turns out that you go to the ER of your local hospital, an alternative that is typically a) not covered by insurance stateside, unless it turns out to be a real emergency, and b) far and away the most expensive of all medical venues to obtain treatment. Still, no other answers were forthcoming, so I bicycled (painfully) to the hospital which, conveniently, is located about a half-mile from my apartment.

By this time, the girth of my left knee was about 4cm more than its sibling, a not inconsiderable amount, and quite warm to the touch as well. The doctor who examined me let out a grunt of surprise, that great Japanese catch-all exclamation, “Hwah!” He told me, through my trusty translator, that I would have to have a brace of blood tests, and an IV drip of some strong antibiotics. Additionally, I would require an assortment of pills, some cold compresses, and daily visits to the ER for the near future to monitor my progress. Oh, and no strenuous exercise, and lots of bed rest, two things I am fairly good at. So now I am on day four, and I am showing marked improvement, both to the doctors and to myself. My CRP, whatever that is, dropped from an astronomical 9-point-something down to 3-point-something (it is supposed to be 0-point-something…); two other of the critical factors were out of whack as well, but they smartened up quickly, and fell into line by day two. It’s only that cranky CRP that is still outside its prescribed limits.

The good news: day one, including the physical exam, a half-hour of face time with the doctor (a specialist, by the way), an IV drip, blood work, and all my prescriptions, set me back a bit less than $120 (I had raided my ATM for $400, my daily limit, and was concerned that it might not be sufficient). The encore visit, which was a shorter time with the doctor (albeit a happier one), plus the IV and blood work, was only $55. Days three and four, which as far as I could tell offered the same regimen as day two, ran $36 each. That’s the “retail” price, not the deductible or co-pay, but the whole enchilada. Are there really people left in the US who think that the American healthcare system doesn’t need an overhaul? If so, please have them phone their nearby medical center and request a quote on the above-referenced services.

In closing, I would like to upload a picture, to show you that even if I have not been able to blog for the past few days, I have not been a total layabout. Well, okay, I have been a layabout, but at least I have been a multi-tasking layabout: