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Japanese Hospitals

I have a cataract. Or at least I did. I'll skip past the details of how and why – I'm not quite a normal case but that is beside the point of this story. In any case, it had to be dealt with. In America, this is a twenty minute out-patient procedure. But this is Japan.

My adventure starts on a positive note. I mentioned my need to a co-worker and, through an executive contact, I soon had an appointment with the head of ophthalmology at a respected hospital that very afternoon. In Japan, relationships mean everything. Encouraged and relieved, I go to the appointment. The doctor, professional and personable, confirms my condition and schedules a series of pre-operation activities. First off is the full physical. Then a thorough series of eye tests, imaging and measurements. Then the results review. Then the operation prep and discussion.

At each of these appointments, they also insist on administering an eye test. The nurse holds a humiliatingly large chart in front of me and I confirm to her that I can barely see it, still. Same nurse, same result, same reaction. Probably ten checks over the period of a month and she registers surprise each time. For some reason her reaction always prompts me to apologize. Why do I have to apologize? It just seems the Japanese thing to do.

On the same day as my physical, I need to confirm my hospital stay for the operation. A three day stay is normally mandated despite the fact that this procedure takes the same amount of time and involves the same, if not higher, level of ultrasonic and laser imaging technologies used in the US. Not wanting to stay any longer than necessary I somehow manage to convince them to limit my time to one day, avoiding entirely any overnight stay. Score one for Team Steve.

Still, I have to make a room reservation. I talk to the In-Patient receptionist. Do you want a room with an air conditioner? What an odd question – it's the middle of August and 100 degrees. There are rooms without air conditioning? Feeling vaguely ripped-off but hot, I nonetheless quickly agree to pay the additional $20 for an air conditioned room. I then go about the day, following a nurse around to various departments where they poke, prod and x-ray various parts of my anatomy while removing associated fluids. Very fun.

The air conditioning thing knocks around my subconscious during the day until my brain finally kicks out, �gRefrigerator, you dolt.�h The two words are somewhat similar in Japanese. For a one day stay? What would I put in it? I cancel the refrigerator.

Finally, the week of the surgery arrives. On Tuesday there is a final review of the procedure with the ophthalmology admissions doctor. Entering the office, the doctor seems startled to see an American. He looks up at me and then around to my side as if there might be a little Japanese woman following in behind me. Is it just you? Yes, it's just me. Can you understand? Until this moment, I hadn't questioned my ability to adequately handle the details of this discussion in Japanese. But I also didn't realize how unfamiliar I was with Japanese medical terminology. Retinal detachment. Cornea replacement. Infection. Hemorrhage. Fun words in any language! We soldier on together as he explains all the risks and side effects that �ghardly ever�h happen but that I should be prepared for. My confidence and enthusiasm for the procedure drop with each new word that is added to my expanding Japanese vocabulary. Soon there is a lineup of young nurses inside the office with nothing better to do than be entertained by this spectacle of cultural interaction.

Nevertheless, feeling the ship has sailed, I arrive for my appointment two days later. A nurse shows me to my room (with $20 refrigerator – so much for the cancellation). We sit down and she goes through what I should expect for the day, culminating with the surgery on my right eye. Right eye? I looked closer at her paperwork. Left eye, I urgently correct her. She scribbles out �gRight�h and writes �gLeft.�h A good start to the day.

Continuing her discussion, she tells me that before the surgery, I will need to wash my face – Do you have facial wash? I needed to bring my own facial wash? Well, just make sure you wash it with whatever you can find. Now, where are the cotton disinfectant pads for your eye? Cotton pads? I had a vague recollection of this discussion from a month ago but it was lost in the background noise of a thousand other oddities in Japan that I mentally file away for later review. Really, they don't provide soap or cotton disinfectant pads?? She mistakes my confusion for a lack of Japanese comprehension. Running from the room she soon returns with the one medical intern who speaks English. He explains I need to go out and buy the pads. Now? I just checked in to the hospital and they want me to go out and buy supplies? Yes. Okay�cI leave the hospital and return 20 minutes later wet from a sudden downpour I was unprepared for but with the required product in hand. $2.

Back at the room I feel lost. I had arrived at 8:30 as instructed. The surgery is scheduled for 2:00. Not a lot to do but stare at my cotton pads and vigorously wash my face with the soap in the restroom. Lunch arrives – a bowl of rice, one small piece of fruit, vegetables, seaweed and tea. If I were here long enough I would surely starve to death, but healthily. Now I know what the refrigerator is for.

Every once in awhile, nurses arrive and administer medication. They tell me to take off my watch and ring for the operation. Just leave it on the nightstand. Just leave it? Japan may be safe but I'm not that stupid. Lacking a safe location to put valuables I stuff them in my backpack.

Finally the big moment. A petite, attractive nurse attaches me to a portable IV and I, feeling foolish, sit in a wheelchair. I tell her that this is embarrassing. She laughs as though I'm trying a pickup line on her. She struggles mightily to push me down the hall, into the elevator and through some secret passageways to the inner sanctum. Then she passes me off to a nurse way past retirement age who enthusiastically starts wheeling me through another door. I look back and realize that the IV stand has been left behind and will soon run out of tubing (firmly attached on the other end via needle and tape to my arm). Alarmed, I scream. She stops, corrals the IV stand and pushes me into the pre-op room.

In the pre-op room, I'm left along a wall. Curtains are drawn around me and there I sit. What function the curtains serve is a mystery. I dub this the Penalty Box. I sit for twenty minutes or so as they administer local anesthetics, antibiotics and possibly experimental drugs of unknown origin for unknown purposes. The curtains open. Heavy stainless steel double doors to the operating room slide open with a swish and an old man is wheeled out. He has a bandage on his eye the size of my fist and looks dazed. If this is psychological warfare, they won the game a long time ago.

Now, I am moved into the OR. The room is bristling with high tech, electronic gadgets, all centered around and pointed at a reclining captain's chair. I feel like a 21st century convict headed for a lethal injection. I settle down into the chair. Looking around I count at least five people. One of them looks at me and says cheerfully in English, �gHow are doing?�h What's an appropriate response? I'm too startled to answer. They secure my head, tape open my eye and insert some medieval looking torture device to fully expose the cornea. A canvas cloth is placed over my face that has a hole for one eye (left, I'm quite relieved to note). Finally an OR light is turned on. It is of unimaginable intensity. The light feels like a laser is searing my consciousness. I cannot blink or look away. I'm reminded of stories of the Wild West where Indians would stake a cowboy to the desert floor at high noon with his eyelids removed.

The problem with a local anesthetic is too much information. I listen to them as they go about the task at hand. �gDoes it go this way?�h �gNo, try the other way.�h �gAre you sure?�h �gI think so.�h �gHmm...very strange�h In the midst of this encouraging banter, an electronic voice from the Raster Blaster Ultra Sonic 9000 Cataracter Remover (possibly not the official name) calls out urgently in English, �gMemory! Memory! Memory!�h accompanied by a rapidly rising tone. I think it might explode. I can hear my heart rate increase on the electronic monitor.

But, finally, they announce that the procedure is done. I'm relieved but disconcerted – I can't see yet. I tell them this. They laugh and remove a cotton patch. My left eye sees only the blackest of black. More concerned, I tell them nothing has changed. Their reaction is one of stunned disbelief. The main doctor says, �gThe operation is over. There weren't any problems. You should be able to see.�h I can't see, I whisper. I hear someone run to a phone and make a series of calls. Soon there is a hive of activity in the room and an air of confused electricity. Several other doctors appear and look, all asking the same question. Can you see this? How about this? This? Nope, nope and nope. Simultaneous to all this, I am going down the mental path of acceptance – if they can't figure out the problem now, I feel doubtful I will ever see out of the left eye. The doctor says, �gwe're going to let you lie down in your room and see if that helps.�h I think of this as the �gReboot Method.�h Maybe if we turn Steve off and on again, he'll start up okay.

They wheel me out first to the Penalty Box and draw the curtains. The doctor appears after a few minutes. She holds up fingers – how many? I strain like mad and realize I can make out the faintest outline of 2 fingers. Hope? They take me back to my room and Christine is there. She doesn't know anything and when I tell her, she starts to cry. But by now, I can see light and color. My vision is returning. The doctor comes to the room and I can now see much more. I ask the doctor what happened. She doesn't know – this has never happened before. But a theory she puts forth is that the light in the OR shut down my optic nerve and it would take time to fully recover. I am so relieved – unbelievably relieved. I'm held overnight for observation (so much for Team Steve). By the next day my vision is back, better than before. That morning the �gHow are doing�h doctor from OR examines me. I tell him that I was quite worried. �gMe too,�h He says. Well, at least he is honest.

And now that I write this, I do so with a clarity that I haven't seen in years. Amazingly, white is whiter and colors are more vivid than my right eye. Maybe I should try for a matching set?

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