Japanese Surgeon's Daily Life

Mesenteric Panniculitis

     The patient showed a high fever of 39 deg C and the X-ray film showed a severe adhesive intestinal obstruction on the 2nd day after the operation. I was so surprised and opened his abdomen. It was only 2 days after the operation, but the shunt tube was surrounded by massive granulation tissue and an abscess had already developed. Unbelievable! I was so surprised to see it. I fixed the cause of the intestinal obstruction and did the abdominal drainage.
     After the operation, I got the pathological report about the specimen which I took out of the patient in the 1st operation. The diagnosis was mesenteric panniculitis. I don't have any experience of the treatment for this disease. I asked my senior colleague for some advice.
He replied: The more you do the operation, the more adhesions will occur. Finally the patient will get seriously ill. You don't want to do the operation if you can find any other way. I decided to give him a low dose of steroids.

Continued from : http://kumo.typepad.jp/weblog/2006/08/a-patient.html

(Vocabulary)
mesenteric panniculitis  腸間膜脂肪織炎

A Patient

     After coming back home from Hokkaido and starting my daily work, I came across a trying case. The patient is 52 years old, suffering from congenital cerebral palsy and the after effects of CVA. He went through the ventriculoperitoneal shunt procedure in the beginning of August. After the operation he had hard bowel movements. Now, he has got intestinal obstruction. Because I couldn't tell that the obstruction is mechanical or paralytic, I've advised medical management. But the condition was getting worse. I decided to do a surgical treatment.
     When I investigated his abdominal cavity, the shunt tube was buried in unhealthy granulation and I found a tumor in the mesenterium of the terminal ileum. I guessed this tumor was benign, but this tumor was apparently the cause of the intestinal obstruction so I decided to do an ileocecal resection. By the way, what is this tumor? Why did it appear? I noticed an unnatural surface of the intestines and abdominal cavity. I've no idea how to express it in English. Anyway it was different from what I had seen before. I asked my senior colleague to help me. He didn't have an exact answer about the status of the abdominal cavity. We decided to observe the patient carefully after the operation.

(Vocabulary)
trying　苦しい、つらい、耐え難い、疲れる、骨の折れる　腹の立つ、腹立たしい、癪に障る
go through　〔困難・試練・つらいことなどを〕体験［経験］する
granulation　肉芽組織　= granulation tissue

The Last Day

     When I woke up, I found that I have a fever and a hangover. It would seem that I caught a cold from yesterday's rain and it got worse because I hit the hay without any quilt or sleeping bag after drinking. I suffered from a severe headache. I couldn't get up until noon.
     It's a cloudy morning. If the weather is fine and good for riding around, It would be most regrettable. Nevertheless I would have got into my sleeping bag and slept early last night if the weather forecast had said that it would have been fine. The party with bike freaks was so nice as I suffered from a hangover.
     The photo shows our bikes parked at the Chitose International Airport. After I parked my bike here, I did the baggage check-in. After taking this snap, I rode to a parking lot, where I entrusted a transportation company with my bike. My bike would be transfered to my house by trucks and ferries. I got on the plane with strong reluctance.
     Thank you if you are one who read this all the way to here. The destination of my next touring trip will be Korea or Sakhalin.

(Vocabulary)
entrust sb with sth  ＜人＞に＜任務・責任など＞をゆだねる, ＜かぎ・金銭など＞を預ける
entrust sth/sb to sb  ＜任務・子供など＞を＜人＞に任せる

 

Riders' House

     Hokkaido is almost a sacred place for vagrants who travel by bike, bicycle, train or on foot. Hokkaido is a vast land and people who live in Hokkaido are broad-minded for vagrants. Many people visit Hokkaido every summer. These vagrants had spent every night in a station, a park, the underground if rained, or somewhere like that. They were not rich and had to save money. People who live in Hokkaido got to give them a night's lodging, using their empty house. Vagrants were very happy to avoid being exposed to the elements and night dew.
     Riders' houses were generated almost spontaneouly like this. There are no baths in most riders' houses. But it's no problem because there are hot springs everywhere in Hokkaido. No beds. It's ok because all vagrants have a sleeping bag. Every riders' house has its own specialty. Owners are unique. I know that 2 Korean bike freaks are reading this touring diary. How about going riders' house-hopping. I proudly assure you that you'll be happy. I have stayed more than 20 nights at riders' houses, but I didn't meet any foreign people. If you visit one of them, you'll be welcomed.
     See the 1st photo. An aged lady who is in the center of the photo is the owner of this riders' house called "Rider House Chitose". She is a retired beautician. After her retirement, she converted her beauty salon into this riders' house. There are a public bath, coin laundries, convenience stores and some eating houses around here within 10 minutes' walk. She said that she was happy to talk with many young people and felt they were like her sons and daughters.
     Strangers get together by chance and spend a night in the same house. I spent a wonderful time. I could share their life. I don't remember how late I slept.

(Vocabulary)
vagrant  放浪者、路上生活者
the elements   《複数扱い》 悪天候

(KW: ライダーハウス千歳 ライダーハウスちとせ)
                               

Takashi Hosokawa

     After we left Fukidashi Park, we ran around Mt.Youtei and Niseko Highland in a counterclockwise direction. The road was wide, except in the forest of Niseko Highland, and not busy. I enjoyed riding to my heart's content. This area is famous for many ski places in winter.  Australians more than Japanese come to this area in winter these days. It seems that people feel like being in Australia. I have never been here in winter. I'd like to be back here in winter, of course, with my ski gear. We rode slowly, enjoying the clear scenery. In about two hours after starting we got to the place on the 1st photo. This photo shows the statue of Mr. Takashi Hosokawa, one of the representative singers of Japan. He was born and raised in Makkari village where we are now and the epitaph on this monument says he introduced Makkari village and its products across Japan. Consequently the number of tourists who visit Makkari village increased and sales of local products grew rapidly. He is an honorary villager of Makkari village. His skill as a singer is there for all to see. The handprints that the 2nd photo shows are on the base of the monument. Each handprint is a switch for playing each representative song. If you touch one of these handprints, you can hear one of his masterpieces. We restarted after a coffee break over his voice. It began to rain after a short time. We ran on route 276 along the lakeside of Shikotsuko Lake and entered Chitose city.
     There are deep forests in the west of Chitose city. The paths in the forest are one of the best places for off-road bike freaks. I'd like to have run on the forest road, but it was closed for some repairs or construction or something. What a pity! We ran through the heavy rain and reached a riders' house "Chitose". I'll write about this riders' house in the next entry.

(Vocabulary)
epitaph　墓碑銘　(人などに対する）最終的評価
honorary  〈肩書・地位・学位などが〉 名誉として与えられる
out for all to see 《be ～》みんなの目にさらけ出されている
The results are there for all to see.  その結果は誰もが認めるところだ。

(KW: 細川たかし 真狩村 羊蹄山 ニセコ)

Spewing Water Park

     Yesterday's forecast said we might get rain all day long today, but I found the weather was getting fine in the morning. We started late in the morning waiting for the improvement in the weather. When I reached the top of the outer rim of a crater of Toyako Lake, I caught the full view of Mt.Youtei, one of the most famous mountains in Hokkaido. I was riding in the comfortable breeze and forgot to take snapshots. I went through Rusutsu Resort and got to Fukidashi Park. Rusutsu Resort was not as busy as I expected. The management might be tough, I thought. The rain and snow fallen on Mt.Youtei seep underground for decades and spew out here at Fukidashi Park. The water is spewing out continuously all year. The amount of water is 80,000 tons per day, which is nearly equivalent to the amount of daily life water for about 300,000 people. The temperature is 6.5 degrees centigrade at all times of the year. The 1st picture shows the spewing orifice. People gather here and take mineral water freely. The 2nd shows the park.

     This water-spewing point is touristy and there are dozen of stands. I found the word "커피" which is Korean for "coffee". I asked the clerk whether many Korean people came here or not. She replied that many Koreans came here but she didn't want them to drop in at her shop because they are impolite and their impudence is too much to tolerate. I sometimes heard such stories here and there.  Is this a common opinion on Korean people around here? I have some acquaintances in South Korea as I wrote before. They are modest and good-tempered.  I'm so sorry that some Korean tourist groups left poor impression here.

(Vocabulary)
seep  〈液体・気体などが〉 しみ出る, しみ込む
touristy  観光色の強い  観光客向けの
impudent = rude and showing no respect to other people

(KW: 京極 噴き出し 公園 湧水 噴き出し公園 羊蹄山 ルスツリゾート)

Eruption Noodle

     This Toyako Spa Area was devastated hopelessly by the eruption of Mt.Usu in 2000. People who live around are struggling to get over the difficulties. I found commercially-minded food there. See the 1st photo. What was written on the advertising display in front of the Chinese noodle shop is "Eruption noodles" if translated into English. What kind of noodle is it?! I dropped in at the shop on the impulse of curiosity. The 2nd photo shows the eruption noodle. It was extremely hot. The naming of this chinese noodle seems to be from the hotness and redness of the eruption. It was unbelievably hot and good. After that I got the breakfast of tomorrow morning in a convenience store and went back to my lodge. I enjoyed the hot spa.
     I wondered what is the happiest reason to be born in Japan?  Natural hot springs are absolutely one of them. What else? Raw fish which we call "sashimi", Japanese alcoholic beverage made from rice, and we can select any kind of motorbike with the best technology in the world. You know, the world championship is centered on 4 big companies; HONDA, KAWASAKI, SUZUKI, and YAMAHA. All of them are Japanese companies. These happiest things I now have!

(Vocabulary)
be centered in/at sth  〈活動などが〉 集中している  ＜場所＞に集中している, を中心に行われる
Most of the fighting is centered in the southeast of the country.
戦闘のほとんどが国の南東部に集中している

(KW: 洞爺湖 噴火ラーメン)

Daiwa Ryokan

     Hokkaido has so many hot springs. There are some hot springs around Toyako Lake where we are now. And there is a rider's house with a hot spring here. We lodged at that rider's house. I guess that the rider's house is maybe unique to Japan, especially to Hokkaido. I'll explain the system of it and how it works later. The 1st picture shows "Daiwa Ryokan", a Japanese style hotel with a rider's house where we put up at. All around Toyako Lake they had catastrophic damage from the eruption of Mt.Usu in 2000 and the reconstruction of this area is still underway. Only a corner of the town, where some gorgeous hotels are located, is full of people and the other area, including our lodging site, is empty in the evening. I just imagined that our hotel had decided to open one floor to riders with a cheap price, due to the tough management situation brought on by the decrease of tourists.
     I took a snapshot at the central tourist site (2nd picture). It was just the start of the festival. I could enjoy fireworks too. I thought I was lucky to be here on the festival day at first, but I heard that the festival was held every day during the summer. It must be an event to pull in more tourists. Someone invited me into the circle of the Bon dance (Japanese traditional dance), and I joined in. After the dance, I got a canned coffee as a token of gratitude for joining in. It was fun.

(KW: 大和旅館 洞爺湖 温泉 ライダーハウス)

Toya Volcano Park

     I ran on the straight road for a while after re-starting. Route 37 was getting to be a slow ascent and I entered into Toyoura town. The weather was getting fine at the same time. I took my rain suit off. During this tour we moved following the onscreen instructions of a state of the art GPS. My friend bought this GPS for this tour. It shows not only the location of us but also the map around us. It was very convenient and more advanced than mine. My GPS is shown in the URL below. See http://kumo.typepad.jp/weblog/2005/11/get-started.html  We could move at ease.

     By the way, just before we reached Toyako Lake, we lost the way. Route 230 was showing on the screen of the GPS, but actually disappeared. Heaven forbid this kind of thing, but the route disappeared. Anyway, we went up the hill to Toyako Lake on another route and found the volcanic smoke of Mt.Usu. at the top of the hill. It reminded me of the eruption which occurred in 2000. Route 230 was ruined at that time, and reconstructed in another place. The eruption was disastrous, but the forecast system was perfect and there was no human damage. Now, this area has become one of the sightseeing points in Hokkaido.

(Vocabulary)
ascent  上り坂
onscreen  スクリーン上の
a state of the art　最新式の　最新鋭の
heaven forbid  そんなことがあってはならないのだが

     The 1st picture shows water-covered area. There is the old route 230 under the water.

     The 2nd picture shows a shredded route 230 and sidewalk on which I'm walking up.

     The 3rd picture shows a newly made explosion crator.

     The last picture shows ruined houses. Those houses are located at a good place and people could enjoy beautiful scenery. I felt sympathy with them because I've just had my house built 3 years ago.

(KW: 洞爺湖 火山 公園 有珠山)

Oshamanbe Local Products Center

     I went up north along the coast of the Funkawan Sea. "Funka" means an eruption of a volcano and "wan" means bay. When you see the map around here, you'll find the shape of the coast looks like an exploded crater. I'm not sure, but there must have been an enormous eruption of a volcano several hundreds of thousands of years ago. I stopped my bike at the Oshamanbe local products center. You can take a rest here and enjoy various products of this area. I'm sending e-mails with pictures to this blog. My friends and my family checked this blog and knew where I was during this tour. It's a simple way to inform many people at once about where I am. I could save time and money. I didn't need to call everyone. I took a coffee break and checked the map. It's about a couple of hours to Toyako Lake. Let's start!

(KW: 長万部)

Ohnuma Circular Parkway

     It was clear and sunny in the morning in Hakodate. I expected the fine weather all day long. About one hour later, when I drove up north and went over a small mountain pass, it started to rain. I made haste to put on my rainsuit. I got to Ohnuma Park. I wanted to see Mt. Komagatake over the surface of Ohnuma Lake, but I couldn't. I just saw the base of Mt. Komagatake. The Ohnuma area has a famous local beer. I'd like to have drunk it, but I had to ride, so I gave it up. I drove along the Ohnuma Lake circular route. I found some campgrounds, a boathouse and some natural parks from place to place. When the weather was clear, I could enjoy beautiful scenery. I saved the time for a rest in Ohnuma, and started for Toyako Lake.

(KW: 大沼公園 函館)

Hakodate

     It's early morning on Aug. 17th in Hakodate city. You can see a hill beyond the sea in the 2nd picture. It's Mt.Hakodate. We tented near the ferry terminal where I got to last night. We were going to camp out almost all the nights during this tour, but the 1st night was on the ferryboat, the 2nd night a free stay in a hotel by courtesy of my friend, 3rd night in my friend's house and the 4th night in a traditional hotel due to a closed, scheduled campground. Consequently the last night was the 1st campout on this tour.
     Both of us prepared a new tent for this tour. I was afraid we might catch a cold, but the protection against the chilliness was perfect. I stayed comfortably in my tent. I renewed my tent for first time in ten years, and was surprised how advanced tent technology had become. It has good ventilation and became more convenient and light. Our camp site was just behind the convenience store. The location was the best, because whenever and whatever we needed, we could get anything. I bought mosquito coils, a small bottle of whisky and some snacks. Drinking and talking with a view of many distant lights of squid-fishing vessels and a fresh breeze from the sea was relaxing.
     To tell the truth, these pictures were taken by my friend. He makes it a rule to get up 5 o'clock every day. When he shot these snaps, I was sleeping in my tent. When I went out of my tent, he had already broken his camp and was waiting for my packing up. I like to start slowly every morning, but he is an early bird. It was the only hardship during the touring.

(Vocabulary)
mosquito coil　蚊取線香
squid-fishing vessels  イカ釣り船
break camp　テントをたたむ

(KW: 函館)

Ferry Aomori-Hakodate

     I came down to Aomori city from the mountain area this evening. I was going to sleep out at the seashore. But, because I came down earlier than scheduled, I decided to pass across Tsugaru Strait and camp out in Hakodate city.
     When I arrived at Aomori city a few days ago, my friend took me to an eating house.  http://kumo.typepad.jp/weblog/2006/08/meeting-after-m.html  I liked it. I dropped in at the eating house again and took the last meal in Aomori. After that I parked my bike at the parking lot of the Ferry Terminal. The pictures below shows the parking lot, the entrance of wheeled vehicles into the ferry and a cabin where I'm sleeping.
     I'm returning to Hokkaido by a different way from the route I reached to Aomori. It's about a 4 hour voyage. I'm taking few hours' nap in the picture. After the arrival I have to find the appropriate place for camping.

(KW: 青森－函館フェリー)

Hakkoda Mountains

     I ascended halfway up the mountain by the Hakkoda Ropeway. I show pictures of Mts. Hakkoda taken from the mountainside. As you can see, Mts. Hakkoda have gentle slopes, no rocks, no spires. The summits are like upside down bowls. I can't believe this was the scene of the most disastrous alpine accident. My friend (see the following URL) living in Mutsu city enjoys ski mountaineering here. I'd like to get together with him, but too far from my hometown. I'm very sorry. http://kumo.typepad.jp/weblog/2006/08/japan-self-defe.html

(Vocabulary)
spire  尖塔

(KW: 八甲田山 ロープウェイ)

Monument of Death March

     Mount Hakkoda is featured with its gentle slope, but is also famous as the place where the worst accident in Japanese Army history occurred. Military leaders of the Japanese Army planned a training exercise against Russia troops during the Meiji Era, about 100 years ago. The plan was to go over the mountain pass at midwinter. Mount Hakkoda is famous for its abundant snow in winter. Over 90% of the soldiers missed the right route and died from the cold. The picture below shows the monument for them. After this alpine accident, the Japanese Army started the ski training under the instruction of the Norway Army. The roots of skiing in Japan comes from this.

(KW: 八甲田山 死の行進 冬山 遭難 雪中行軍)

Oirase Stream

     This is the only stream from Lake Towada. It flows down like wine spilling from a wine glass. When I heard the name of Oirase, I felt comfortable. The sound "Oirase" has something traditional about it. We drove down along the stream.
     During the drive down, an idea came up. I don't remember exactly, but I knew about Oirase Stream from books, maps or similar things. Anyway I was riding down after knowing there's an untouched stream from Lake Towada.
     When a man climbed up along the stream long, long ago, how was the situation? I imagined he didn't know there was a big beautiful lake far up the stream. He must have climbed up along the stream, pushing aside much of the bush with expectations. Finally, he found the big lake. I can't imagine how much delight and surprise he got. I envy him, the first person to see this lake and stream.

(KW: 奥入瀬渓流)

Lake Towada

     I got to Lake Towada, after a bathing spa in the morning. Lake Towada is one of the famous caldera lakes in Japan and one of the popular sightseeing points. It's always lively and full of people. I took the 1st picture from the highest viewpoint around the lake and the 2nd picture at the lakeside. Every parking lot was crowded. We parked our bikes as you can see in the 3rd picture. It is very convenient that I can park my bike almost anywhere legally.

(Vocabulary)
lively (場所・状況などが) 活気ある, にぎやかな

(KW: 十和田湖)

Sukayu Hot Spa

     I was riding my bike on and on on route 394 and reached Sukayu Spa. I didn't take a rest for about 2 hours because the riding in this area was too comfortable to stop my bike. Consequently, to my regret, I couldn't take snapshots around here. I might have to equip my bike with an onboard camera which I can use during riding.
     Let me explain Sukayu Spa. The source of hot water of this spa was found 300 years ago. Then the history of this spa started. This spa was nicknamed "Sen-nin Buro", which means that 1000 persons can bathe at once. As you see in the photo in the URL above, this spa is mixed. Misawa Base of the U.S. Air Force is near here, about 1 hour by car. I met several Americans here. I felt that those Americans living in Aomori Prefecture were lucky to be able to bathe here.
     We were going to stay at the campground attached to Sukayu Spa. In order to do so, we prepared newly bought tents. But the campground was under renewal work, so we coundn't sleep under canvas.
     Out of necessity, we put up at the Sukayu Onsen (Japanese traditional style hotel). The photo shows the motorcycle parking lot of Sukayu Onsen Hotel.
     You'll find some bikes in the photo. The one on the extreme right one was made in Germany. Yes, it was a BMW. I was moved by the equipment, beauty, and decency of this BMW. I decided to get a BMW in the near future. Maybe I'll go touring next time with a BMW. The destination at that time will be Korea or Karafuto (Sakhalin).

(Vocabulary)
canvas　テント地　画布　（カンバスに描いた）油絵　《海事》帆　テント
put up  宿泊させる 宿泊する 宿を貸す［提供する］ 泊める 泊まる

 (KW: 酸ヶ湯温泉)

Comfortable Road

     I drove down south along the coastline of Mutsu Bay from Yokohama town and crossed Shimokita Peninsula from west to east (to the Pacific Ocean side) on prefectural route 24. I ran through a virgin forest and a few ranches. It was wonderful going over a mountain pass.
     Then I reached a nuclear complex on the Pacific side. We were in the Rokkasho village where there are no private houses. This area might be good for nuclear facilities. The road is wide and not tight. I think it's because this road is used for the transportation of nuclear substances. Nuclear spent fuel that is produced in my prefecture is stored here too for a long long time.
     On the picture, the road goes across Takahokonuma Lake. This lake is brackish and Mutsu Ogawara Port is located at the outlet to the Pacific Ocean. The lake on the right side of the road is desalinated.
     After passing Takahokonuma Lake, I turned to Route 394 and ran through several tranquil roads.
     Soon I got into Shichinohe city. The road had a noticeable uphill gradient that ran through a deep forest. I got to see the Hakkoda mountains in front of me.
     It was a clear sky and the wind was confortable. My speed became high unconsciously, so I had to be more careful than usual.

(Vocabulary)
nuclear complex　核の複合施設、核関連施設
nuclear spent fuel　使用済み核燃料
brackish　汽水性の、半塩水の
desalinated water　脱塩水
tranquil　落ち着いた、平静な、平穏な、穏やかな、のどかな、安らかな、静かな
noticeable　人目を引く、目立つ、顕著な、注目に値する
uphill　上り坂
gradient　傾き、傾斜、勾配

(KW: 六ヶ所村 鷹架沼 たかほこぬま 七戸市) 

Rest Stop "Michino-eki": Yokohama Town

     I don't know whether "Road Station" is a proper translation or not. There are many parking lots across Japan that we call "Michino-eki". Every Michino-eki has some restaurants, vending machines and washrooms. We can get information about routes and local news and events. It's very convenient. We are in Michino-eki Yokohama town now.