Japanese Surgeon's Daily Life

New Job

　　I moved to another office which is located an hour away from my house. It is near my birthplace and people had worried about a lack of surgeons. I had been asked to work there for a long time and I decided to accept their wish. The new office is only an hour by car from my house, but two hours there and back for driving is too much, so I made up my mind to utilize the train for commuting. I have to walk for 20 minutes to the station, but it will be good exercise. The train runs slowly for an hour along the seaside which is said to be one of the best scenes in my prefecture. This train ride will give me time for reflection. The pictures below were taken from atop the hill behind the new office on the day when I visited it for the contract. About half of the inhabitants work in fishing or its related industries and the town is very peaceful.

(Vocabulary)
there and back  往復で
give someone time for reflection　（人）に思索の時間を与える

Tired

　　I was coffeed out today. I had no consultation appointments. Moreover there were few inpatients. You might think that I had spent a very relaxing time. However, I had lots of desk jobs left, like the paperwork of charging the cost of medical treatment for the Fee Payments Fund, recording the summaries of hospitalization therapies of all the inpatients and writing other official certifications.
　　I can see some people walking outside in comfortable sunshine. I could manage to control myself from going out and did a week's worth of work.

(Vocabulary)
I'm coffeed out today.  今日はコーヒーを飲みすぎた。
paperwork  文書事務, 事務作業
Act Concerning the Social Medical Fee Payments Fund  社会保険診療報酬支払基金法
hospital care / treatment // hospitalization therapy  入院治療

Move

　　I decided to move to another hospital, which is located near my original home. Not only the head but all the staff members of the hospital, along with the local residents, had been asking me to work at their hospital for a long time. The hospital is about one hour and a half away from my house, but the highway to the hospital is getting improved; commuting time will be an hour next year.
　　The hospital is in a rural fishery village facing the Seto Inland Sea. Lots of new topics concerning the sea will be added in this blog from the autumn. For now, I'm thinking of taking a month off between the move. I have friends whom I haven't seen for more than 20 years and am now eager to see them again. I wonder if I could do a journey to visit them on my scooter. Just as I travelled across the country in my student days, I'm thinking of setting out with several pieces of camping gear. It's kind of an adventure. If this adventure became real, I'll be sure to take my PC and upload my trip memos on the net, which wasn't even imagined in my 20s.
　　I'll post the plan on the top page of this blog later and keep it there for a few months until the end of the trip, though it will be written in Japanese. The newest entry will be arranged on the second page.

(Vocabulary from comments)
embark on sth  ＜旅＞に出る
embark for sth  ＜場所＞に向けて旅立つ
embark on/upon sth  [句動詞]＜…＞に乗り出す, を開始する

Ten Eggs

　　A patient gave me ten eggs which his hens laid this morning. He breeds lots of hens organically. His hens seem to stay outside in the sunshine in the daytime and freely walk or run on the ground which is kept untouched. I'm in another office now and have to stay until tomorow morning. What should I do with these eggs? I don't have any cooking equipment except an electric pot, if it can be called cooking equipment.
　　My coworkers told me that his hens were great and popular regionally, but the eggs are usually laid scattered all over the farm. The farm personnel collect them every morning, but they can not always pick all of them up. That is to say, some of the eggs might have been laid before yesterday and had been left on the ground for more than a day. They advised me not to reserve them because of the possible deterioration. I had better not take them home.
　　In this way, I had to cook or deal with them in a very short time and so I tried to put the eggs into an electric pot, though I wasn't confident about the result. What do you think became of them? Left in the pot for about an hour, the eggs were nicely cooked. They were genuinely hard-boiled eggs.

(Vocabulary)
lay
[他] 〈鳥・昆虫などが〉 〈卵〉 を産む
[自] 卵を産む
breed 〈動植物〉を繁殖させる, 飼育［栽培］する, 品種改良する
They breed cattle. 彼らは牛を飼育している．

Erasing Data from HDD

　　I use my PCs in both my office and my home. The data is stored on both PCs' HDD and on the internet so that I can do some deskwork also in my home. It is a very comfortable working circumstance, but one of my those PCs got outdated and I decided to throw it away. The data on its HDD was erased totally by myself, I believed, but the PC experts apparently can revive the data. That was why I took the PC to the Medical Association that I belong to. The association has a data-erasing machine and this machine can make the HDD eternally unusable by strong magnetic energy. I'll show you the picture of the machine. It took about ten minutes to clear the HDD and the private data on the patients was completely erased.

Human Testing

　　I felt a slight chill last night and went to bed earlier than usual. I usually don't take medicines with a cold, but I thought it was a valuable opportunity to try medicines myself. I conducted some human testing. I also had a stiff shoulder and posterior cervical pain. I took a Japanese herbal medicine for these symptoms and this was really effective. I will be able to prescribe this medicine confidently. However, the diarrhea began. At first it was like water, but it gradually changed to formed stool. Do you understand what I mean by "formed stools"? I used this term to describe the stools which aren't watery. If you know a better expression please tell me. Anyway, I took another herbal medicine for diarrhea, but it wasn't good for me. It was a good lesson.

(Vocabulary)
human testing/experiment 人体実験
formed stool 有形便
dyspeptic  消化不良性の

Memorable Patient

　　It's terribly cold. Such coldness in January reminds me of a patient who had been under my care for five years. He passed away at the end of the last winter. He was a victim of the atomic bombs. I wrote "bombs" in the plural not in the singular. To tell the truth, he visited both victim cities, Hiroshima and Nagasaki, just after the bombings, to help take care of live victims and recover bodies from wreckage and the river, where a number of people dived into for water. Ordinary people didn't know the danger of the residual radiation at that time. He wasn't supposed to be exposed to the radiation. His condition suddenly got worse on such a freezing day last January and he didn't come back again.
　　I'd like to write about victims of the atomic bombs. Most people in the world might think that the bombings are something that is done or passed long ago, but it's not true. The cruel influence of the atomic bombs is still continuing. Six months after his death, his wife visited the victim city, Hiroshima, commemorating the 65th anniversary of the first-ever atomic bombing. Her comment and picture were put on the local newspaper and I'm showing it later.
　　I'm angry about the attitude of the U.S. that has never apologized about the bombing. They made the convenient story up to protect themselves, but if you ask me, there is no rational excuse about the bombing. They attacked people who were not resisting, not only in this case, but also in lots of cities in Japan. Kamikaze never attacked the transport ships that didn't have the measures of attacks, following the international laws, but the U.S. did indiscriminately. It should have been the U.S., not Japan, to be judged in the Tokyo tribunal. My heart bleeds recalling his words.
　　At last, I'll post the article of the commemoration of the 65th anniversary of the bombing in Hiroshima. The woman in the picture is his wife. I don't want to be bombed again. I insist that Japan should have the nuclear weapons unless all the countries throw the nuclear weapons away altogether. Japan is a single victim country of the nuclear weapons, so only Japan has the right to have the nuclear weapons to protect ourselves.

(Vocabulary)
memorable / unforgettable sight 忘れられない光景
in sb's care  ＜人＞の世話になっている
under sb's care  ＜人＞の世話［治療］を受けている
in the plural  複数形で
the danger of sth/of doing sth  ＜…＞の［＜…＞する］危険性
an indiscriminate attack / random attack 無差別攻撃
commemoration 記念, 記念式典, 記念物［碑］

 
 
 
 
 

Jan. 17th

　　16 years ago today, the Great Hanshin earthquake broke out in the Kobe-centered area in Japan. It was early morning. More than 6000 people were trapped dead in their houses. I remember the day just like yesterday. I happened to wake up earlier and saw people commemorating the 16th anniversary of the earthquake in the dark on TV.
　　Time flies. I was working in the university hospital at that time, and was sent to Kobe city as a member of the rescue team from the university. The transport measures were destroyed hopelessly around the city. Lots of people who had something to do with Kobe city carried necessities to their acquaintances on foot from adjacent areas, like Osaka.
　　It was the first time for the university to deploy medical personnel to such affected areas. We were not accustomed so that the preparation needed two days. A few fishery boats were chartered for the transport to Kobe. The Kobe port was also destroyed and our boats arrived at the shore which looked to be easy to get off the boats.
　　The scene of the commemoration reminded me of the rescue activities, during which I couldn't even take a shower. As for the shower, several days after our arrival, the Japan Self-defence Force set up the public bath near our camp. To my surpirse, they sounded like they could build the bridge, the paved road and even the port. It's wonderful.

(Vocabulary)
~ years ago today  ～年前の今日
Great Hanshin earthquake　阪神淡路大震災
deploy 〈人・装備・資源など〉 を動員する, 活用する

Hollow Operation?, Gastrojejunostomy

　　I do various operations as a general surgeon. Gastrojejunostomy is one of the operations which I specialize in. It's a kind of bypass operation of the alimentary tract. The stomach and upper intestine are connected by this method. When there's something in the stomach outlet or duodenum which narrows the alimentary canal or blocks the flow of food, the patient undergoes gastrojejunostomy if he/she wants to be able to eat something. If not, the patient would be fed by the intravenous hyperalimentation without any oral intake until his/her death. It means that the patient under this alimentation would never be able to leave the hospital.
　　The patient was a 55 year-old sincere man who had kept working for his family for a long time. His life looked like a thorny path. After his daughters got married, just when he was relieved, stomach cancer was found in him along with multiple hepatic metastasis. He consulted me complaining of frequent vomiting and that he couldn't eat meals. He was promptly diagnosed in the terminal stage of stomach cancer with a gastroscopy test and CT scan. He calmly accepted the reality. His daughters, however, were frantic. After going wild crying, they asked me to make him live longer to build good memories with him. They had never enjoyed family trips, and they hoped for a two-night family trip to a hot spring. This trip must be the first and last family trip for them. I took on their last desire. Their trip was scheduled on Feb. 11th, which is National Foundation Day.
　　I performed a gastrojejunostomy today. The inside of his abdomen was terrible and worse than I had expected. The operation was successful, but I was afraid the invasion of the cancer would advance to the anastomosis site in a few months. I just hope that he would be able to eat as early as possible and spend ordinary days at home for as long as possible.
　　In such cases, gastrojejunostomy isn't a curable method, but I think it is significant way of thinking for producing precious time toward the end of the life, though some surgeons don't think so.

(Vocabulary)
hollow〈行動・結果などが〉 むなしい, 無意味な, 価値のない
a hollow victory  むなしい勝利
stomach exit / stomach outlet  胃の出口
thorny path  いばらの道
frantically 半狂乱で
go wild doing  半狂乱で～する
take on（仕事・責任などを / 医者が患者を）引き受ける
anastomosis site 吻合部

January 4th

　　It is the day when all the public offices start routine work across the country in Japan. My office is likewise. Just before the opening of the opd, the principal staff members were required to get together in the conference room and receive a motivational talk from the head director.
Anyway, the year 2011 just actually started today. I wish lots of happy things may happen to me.

(Vocabulary)
public office 官公庁
motivational 人をやる気にさせる
head director 理事長

Last Business Day

　　Today was the last business day at my hospital. The opd section was closed and will be open on Jan. 4th next year. The staff members are supposed to be on duty by rotation for this interval. They have only to look after our inpatients.
　　Having said that, to our regret however, my hospital was assigned to be an emergency hospital on New Year's Day. Lots of outpatients will see us on that day and the opd will be packed, because only two hospitals, including my hospital, will be open in my hometown. Thinking about such a New Year's Day, I felt dizzy.
　　Anyway, I have to go on the rounds once a day for the coming several days, but I'm free from duty except for the rounds. What shall I do?

(Vocabulary)
be supposed to do sth  ＜…＞することになっている, ＜…＞しなければならない
We're supposed to check out of the hotel by 11:00.  我々は１１時までにホテルをチェックアウトしなければならない．
by rotation  交代で
go on the rounds （医師が）回診する

Volunteer for Blood Donation

　　Japan is short of blood for transfusions now. Years ago, Japan abandoned the blood-selling system, and now is collecting blood from goodwill people. Japan adopted the blood donation system for collecting blood and set up some facilities for blood donation in the heart of middle-sized and  bigger cities. Beside the fixed spots, lots of blood donation buses collect blood by traveling all over the country.
　　As I wrote before, I belong to a Lions Club and as a part of its activities, I voluntarily joined the campaign for blood donation which was held on the campus of Ehime University, where the University festival was performed. The picture shows the bus designated for collecting blood. My job was calling for students and visitors to give blood for patients.
　　One more thing. The scene of the festival reminded me of my good old days. A stage was set up next to our site, and I could enjoy lots of performances. Though I was there as a staff member of the Japanese Red Cross, I didn't feel obligated and spent a really relaxing time.

(Vocabulary)
obliged;
be obliged to do sth  ＜…＞せざるをえない, ＜…＞しなければならない
You're not obliged to tell her anything.  彼女には何も言わなくて結構です．
obligated;
obligated to do sth  ＜…＞する義務がある, ＜…＞しなければならない
feel obligated (to do sth)  （＜…＞する）義務があると感じる

Today's Breakfast

　　The picture shows today's breakfast for inpatients and me. I stayed at my hospital last night and it's also my duty to have the same breakfast as the inpatients' and leave some comments for the nutritionists and staff members of the food service. To tell the truth, it wasn't so good. It might be good for the health, but its taste was bland. The salt and fat are restricted for preventing hypertension and obesity.
　　I have been eating hospital meals for more than a quarter of a century. I think the supper and breakfast before and after night duty, and the everyday lunch must have contributed to my health. My laboratory results are totally within a normal range. I can't believe that this fact hasn't anything to do with hospital meals.

(Vocabulary)
dietician / dietitian / expert in nutrition / nutritionist 栄養士
bland  味けない, 平凡な; (料理・食品などが)味に特徴がない, 淡白な; (表情・口調などが)感情を抑えた(表に出さない), （意見などが）控えめな, 当たり障りのない

Medical Check Up

　　I had a check up yesterday. All the results haven't come back yet, but I knew that the gastroscope test was good. No malignant tissue was found in my stomach and duodenum. Japanese people have more possibility of suffering from gastric cancer than Anglo-Saxons. So, the gastroscope test is set among the routine items of medical check ups of people whose age is 40 and over.
　　I had gone for a check up three years ago just like this time. At that time, the gastrocamera was inserted into my stomach through my nasal cavity, and this method was getting the main stream of the screening test and it was less painful.
　　However, this time  the test was through my mouth. I had cross-exercised how to do the gastroscope test with my colleagues when I was a doctor-in-training. My colleagues, as well as me, didn't master the procedure and it was really painful. Since then, I didn't want to undergo the test and have eluded the test all the time.
　　Now, my wife didn't allow me to avoid the test this time, and I was sorry to be set on the examination table like a poor experimental animal. I appealled to the doctor in charge for some sedative.
　　The effect of the sedative was wonderful, but I couldn't do my work till noon.

• (Vocabulary)
• have/go for a check up 健康診断を受ける
• nasal cavity 鼻腔
• doctor-in-training / trainee doctor 研修医
• guy in charge / person in charge 担当者

Long Time No See

　　I've not known whether I'm coming or going these last couple of weeks. Additionally, I have been depressed and have managed to do my routine work and consequently I have been away from writing entries. Now, I'm getting healed up day by day.
　　Today, my hometown was hit by torrential rain. The shortage of water in the summer is a big issue in my hometown every year, but the water looks like it's enough for surviving this summer. Fortunately, there was no human damage and my house, of course, didn't get damaged.
　　On the news programs, the main topic is the result of the Upper House election conducted on July 11th. The ruling party suffered a heavy defeat, and this is what I was waiting for.
　　Tomorrow, I have to get a medical check up and I feel sluggish for I have to undergo a gastroscopy test. I have a strong vomiting reflex and will feel pain to some extent. I decided to think this way; It's not bad to know the patients' feelings.
　　Anyway, I'm alive and fine. While I didn't post any articles into my blog, some of my friends were afraid that I might be in big trouble. Thank you for your concern.
　　The picture is of my second daughter, who lives in Germany. I guess that she was cheering for the German National Soccer Team outdoors with many people.

• (Vocabulary)
• feel depressed / down / heavy / sluggish 気が重い
• vomiting reflex 嘔吐反射
• patient with diminished gag reflex 嘔吐反射の低下している患者

Temporary Job

　　My acquaintance, who is a physician running a private hospital, asked me to stay for some time in her hospital, because she had something to do for her daughter. She and her husband went somewhere and I'm staying in her hospital now. About 80 inpatients are almost motionless, and I'm so bored now.
　　I brought some books to kill time, but I don't feel like reading them, because the outside is totally sunny and a welcoming breeze is coming into my room. I'm frustrated. I wonder whether to take a walk around the hospital. This hospital is located in a rural fishing village. Only 10 minutes' walk is enough to feel the sea breeze.
　　Not a few people have sent me e-mails for years and some of the senders are really in miserable or dangerous conditions. If I didn't receive their e-mails, I wouldn't notice how happy the Japanese people are. The Soccer World Cup is just around the corner. I heard the security in South Africa, where the event will be held, was the worst level in the world. I wondered that people could fully enjoy watching the game in such a dangerous country. Anyway, in a secure non-stressful country, I'm enjoying passing the time by going around the nearby park and the seashore.

• (Vocabulary)
• motionless 身動きしない, じっとした
• hospitable (人が)もてなしのよい, 歓待する;(場所・環境などが)快適な, 居心地のよい;(ビジネス環境・市場などが)適した, 好条件の [反意] inhospitable
• welcoming (人・表情などが）歓迎する, 歓迎を表した；（場所が）くつろげる
• fishing village [C] 漁村
• pass the time ひまをつぶす

Coroner's Inquest

　　I often see the scene of the coroner's inquests in American movies. The heros like Columbo or Dirty Harry have talks with the coroner and get some clues at his office. I compared both inquests between an American movie and in real Japan. I guess that American coroners have medical licenses and, if they want, they could become clinicians, but they chose to become coroners by their own choice. It's my understanding. At this point, a question came up. Though the number of coroners isn't enough in Japan, how about in the U.S.? The population of my hometown is 500,000, but the number of coroners is one-digit at most.
　　If the body that is suspected to have been possibly killed by a certain third person is found in my hometown, plural policemen and a clinician get together and have a conference to investigate the cause of the death. Not a coroner but a clinician gets involved in such cases. I'm sometimes called to this meeting because of the lack of coroners. I'm not a professional in this field and always feel concerned about the decision.
　　The area where Columbo or Dirty Harry works is a huge city such as Los Angeles and San Francisco. What's the condition of small cities of 500,000 population in the U.S.? Are there enough coroners in rural cities? Does the government control the number of coroners?

(Vocabulary)
coroner  検死官
the coroner's office 検死局
coroner's inquest 検死審問
medical licence  医師免許
clinician  臨床医
by one's own choice  自分自身の選択によって
at most  多くても
third person  第三者

Folk Medicine

　　One of my patients has frequent attacks of the hiccups, and the attacks usually continue for more than a week. During the attacks, he can't eat enough and I have to give him continuous drip infusions. I'd been looking for some remedies and found a strange medicine. It's the stalk end of the Japanese persimmon. You put them into water and boil them. The extracted liquid is given to the patients. When the state-of-the-art medicine reaches an impasse, a folk medicine, existing for more than 1000 years, is available. Don't you think it is funny and an awesome feeling about our ancestors' wisdom?

(Vocabulary)

folk medicine  民間療法

stalk end  へた

Japanese persimmon  《植物》柿

extracted liquid  抽出液

impasse  行き詰まり, 袋小路

reach an impasse  行き詰まる, 暗礁に乗り上げる

be at an impasse   行き詰まっている, 暗礁に乗り上げている

 

Japanese Herbal Medicine

　　I attended a lecture about Japanese herbal medicine. When I finished at my university,  herbal medicine was not popular. Most students didn't give it the time of day. Herbal medicine used to be disregarded as folk quackery. So, I don't have enough knowledge about it and have to learn it now. In the lecture, two volunteers were kind enough to be the patients for participants' learning. I learned how to pick out the physical findings from them under the instruction of a practitioner of traditional herbal medicine.

　　I think that it is the same in a variety of other fields, and I realize that I have to learn all the time as long as I work as a surgeon.

(Vocabulary)

not give someone the time of day  見向きもしない

【語源】Good afternoon.やGood morning.などの「１日のうちの時(the time of day )」を示す挨拶を人にしないという意味

disregard  …を無視する, 軽視する

quackery  いんちき療法

medicine には the は付かない

Palliative Care Workshop

　　I'll write about my job, the medical service in Japan, this time. As most of you know, it is almost totally under the control of the government. The uniform services are available for everyone, no matter how high-profile or poor he or she is. As far as I know, this system is one of the best kinds of medicine in the world.

　　When the government wants to put an emphasis on a special issue, they have only to raise the National Health Insurance (NHI) point of the issue. For example, the number of obstetricians diminished in recent years and the government advanced an NHI point of obstetrical procedures at that time. Consequently the number is now recovering.

　　Today's topic, "Palliative Care", is quite simply the issue that the government intends to concentrate on these days. It's the notion that medical staff remove the agony from terminal patients suffering from incurable cancers and lead them to a peaceful end of their lives.

　　The Japanese Government increased the NHI point of this field last year and it had a condition. That is, it must be under a specialist's direction, having the license of a medical doctor and having attended and got through the palliative care workshop.

　　I joined this workshop today and successfully finished. It was really useful and I acquired lots of knowledge and procedures. I will take advantage of these acquired skills from now on.

(Vocabulary)

palliative care  緩和ケア

palliative

〈治療法・効果などが〉 (根治するのではなく) （症状［苦痛］）緩和の, 姑息(こそく)な

〈対策などが〉一時しのぎの

orientation  [C,U] (政治的・宗教的な) 方向性, 信条

sb's political/religious orientation  ＜人＞の政治的［宗教的］信条［方向性］

uniform 〈外見・性質などが〉 同一の, 均一［均質］の

The country needs a uniform legal system. 国家には一貫した法制度が必要である．

National Health Insurance  国民健康保険          NHI point  保険点数

obstetrician  産科医                                        gynecologist  婦人科医

quite simply  まさに                                        direction  [U] 管理, 指揮, 監督

under sb's direction  ＜人＞の指揮のもとに