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Tuesday, May 9, 2006
WORDS TO LIVE BY
Kae Wakita, 35, is a dermatologist and owner of Skin Solution Clinic in Shintomicho, not far from Tokyo's Ginza area. A confessed workaholic, she is perfectly happy with her life but not with the state of the Japanese medical system. She does, however, have a few good ideas about how to treat this ailing patient.
Doctors need to be interested in people, not diseases. The main reason to become a doctor should be an interest in people and a strong desire to help and serve others. We need kids who love psychology, history, literature and art to be physicians.
Now the people least suited to become doctors get into medical schools. The emphasis on math and natural sciences for the entrance exam is wrongheaded.
Most Japanese patients love scary, condescending and arrogant doctors, simply because patients have been abused by such mean physicians for too long. Sadly, patients expect and accept the maltreatment willingly: They are used to it.
Being kind, patient and a woman is probably the worst combination for a doctor. Even if she is a genius and the greatest physician, few believe she can do more than check a patient's temperature and call in the real doctor, who is, of course a male authority figure to whom the patient must apologize for taking up his precious time.
I want what nobody has. I always look for unique things and never buy famous brands because I think it is silly to follow the crowd.
There is no competition between hospitals and so there is no competition for jobs, either. Doctors from the same medical school stay together in the same hospitals for many years, often till their retirement. In this system their jobs are guaranteed, and therefore they behave like bureaucrats: superior and aloof. They also cover each other's back and protect themselves and their schools.
Natto (fermented beans) and red wine are a great match. At night, I drink a glass of red wine and eat rice and natto. This combination is delicious and does wonders for the skin because red wine is high in polyphenol and natto is full of so many healthy ingredients, such as isoflavone, which is very beneficial for the skin.
Patients should be treated as clients or important customers, because they are. In my clinic I take care of patients like I would like to be treated. We take appointments, have spacious private rooms with heavy doors, not curtains, to protect people's privacy, and nobody is called by their names in front of others. Patients pay in the treatment rooms and I spend a long time talking to them and learning about them. I know this is basic stuff, but in Japan it is special treatment.
I have almost given up on finding a partner. I want a man whom I can respect, but most guys are just too weak or married. A cool man is one who has dreams and makes an effort, works hard and succeeds. His dream is not making lots of money but to be of service to others. He is proud and responsible. Where is he?
At least half of all public servants should be fired. They are misusing the national budget and our taxes. Go to any city hall and you see hundreds of people sitting around shuffling documents in often gorgeously designed buildings. The money we spend on them needs to be used for health care instead.
Men and women's roles are a mess. Most men are wimps without any sense of responsibility, so next to them, any woman seems too strong. I am one of those women.
The outpatient system is out of control. For a three-hour wait one gets a three-minute consultation. The problem is that most people go to big hospitals on their first visit, instead of the local clinic. If I use 30 minutes to see one patient, I still get paid the same as the doctor who takes only three minutes.
I always do what nobody dares try. I opened a clinic in Shintomicho, where very few clinics operate due to the outrageous rents. Most other clinics in this area do not accept health insurance, but I do. I am in the red every month. So to stay in business, I must do profitable procedures like laser hair removal.
Medicine is really expensive, but why? It seems that there is virtually no competition among pharmaceutical companies. The market is tightly shut and the markups must be huge, but I am actually not sure why the prices are so high.
My father is the greatest influence on my life. I am the oldest of three daughters, and we all became doctors because we adore him. He is a physician, and just like Akahige, who was a famous (Edo Period) doctor, he is unselfish and motivated to cure people because he cares. Making money is not a priority for him or for us.
I hate expensive restaurants. I rarely go to fancy places, but every time I do, I feel the same: the price is not proportional to the taste. I love simple mom-and-pop shops with wonderful home cooking and an unpretentious atmosphere.
Japanese love pain and suffering. Enduring pain is considered the sign of maturity and our medical system is based on this principle. This is why we never even think about giving pain killers. Let the patient suffer, they say. It makes them stronger.
Tokyo people are much kinder than I expected. I am from Nagoya where people always say Tokyo is a cold place, but they are wrong.
Looks like I'll be single forever. Ideally, I would like to be married and have a baby but I can't find a husband and I don't even have time to have a baby. I'll probably end up living happily with a couple of dogs.
My patients take care of my advertising. They bring their friends and send me cute letters and even bring me lots of gifts, such as tofu, cherries, veggies and pickled squid, which is my favorite food. Once I got a whole octopus, which was quite difficult to squeeze into my fridge.
The Japanese medical system is really behind the rest of the world. In super-developed Japan it is a shame to see the nightmarish condition of most hospitals. Many are old buildings in need of renovation, but they have no money. The industry itself is not healthy because it's not competitive. Despite this, Japanese doctors and nurses are doing a great job.
I work all day and night. In the evening I look at the next day's schedule and think about each patient's treatment. In my dreams, I keep talking to them and trying various procedures. I guess it's kind of sickness, but I don't need a cure. I am happy this way.
Judit Kawaguchi loves to listen. She is a volunteer counselor and a TV reporter on NHK's "Weekend Japanology" www.nhk.or.jp/nhkworld/english/japanology_e.html