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Alarm over the death of a doctor ripples across the Seto Inland Sea

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I was at the port buying a ferry ticket to the mainland when I first heard the news. “The doctor died last night in his bed!” someone said to me. “Komatta, ne!” Yes, it was problematic, but not necessarily for the immediate reasons you’d think.

There is only one medical clinic for the population of 550 people on Shiraishi, our island in the Seto inland Sea. Our very kind doctor, who was known to dispense medicine without requiring a medical exam, was 78. A darling diminutive man with a robust head of hair and a frail voice, he donned a suit every day and led a relentless life of doctoring, which may very well have done him in. Two days a week he visited outlying islands with declining populations where there were no longer medical practitioners. While he served our local populace four days a week, two of those days were open to patients from the island next door (of 200 people), patients who came over on the ferry as necessary.

More than a medical doctor, he was a prescriber of medicines and distributor of mental salves. When I went to him for a sprained ankle, he could offer only pain medication, and I had to wait a full week before I was mobile enough to get to a mainland clinic with an orthopedic surgeon, X-ray machines and crutches. When I went to our dear doctor for body aches, he prescribed rest. When I went to him with a bout of lateral epicondylitis (tennis elbow), he suggested nothing more than elbow R&R.

Every morning the faithful elderly under his care would line up outside the moldering clinic, a structure that doubled as his house. The islanders are prone to waking up early, and there was always a line of elderly, bent over like fishhooks, leaning on their canes or carts, waiting for the doors to open. It would take the doctor all day to work through a waiting room full of patients with tractable conditions. The waiting room possessed a social life of its own, as islanders from here and there ebbed in and out, gossiping among each other, each aware of the risk of becoming the victim of denigration themselves.

The doctor’s wife, who suffered from mental illness, had long ago moved off the island, but the stalwart professional continued to serve his people, even into his retirement. After all, if he didn’t do it, who would?

Indeed, now that he couldn’t do it, who would? Komatta, ne? Almost immediately, the mood had shifted from pity to alarm at the prospect of there no longer being a doctor on the island. I was startled and incensed that the islanders only had their own needs in mind. The absence of a doctor — the very thing that this kindhearted man had indefatigably worked so hard to prevent — had soon eclipsed the death of the man himself as the prime concern among his followers.

But in a polite society, hindering others is not looked upon keenly. The most inconvenient thing you can do is die, especially if people depended on you not to do so. It’s the patients who usually die, not the doctor.

It has been months now, and at the town meetings the old people are demanding to know why it’s taking so long to get a new doctor on the island. Why can’t they send a temporary medical professional in the meantime? Authorities from the local hospitals attend the meetings to try to explain things — the process of finding a qualified and willing candidate, the selection process, the board meetings, the red tape, the paper work, all to help appease the islanders — but the islanders are having none of it. The raddled residents are angry, and I expect that tomorrow they’ll have created a picket line outside the old clinic demanding our dear doctor be brought back to life.

In that circumspect Japanese way, rather than evaluating the current situation, the residents are focused on projected circumstances, asking “What if … ?” and “What about when … ?” — things that haven’t happened yet. I suppose that the elderly take worrying to a whole new level because their future is tomorrow and their distant future is the day after tomorrow.

The immutable fact is that the residents can still see a doctor; they just have to take a 20-minute ferry ride (with government-issued discounted, or free, vouchers for the elderly) to a clinic on the mainland. Is anyone actually in need of urgent care here on the island? No. If they did have a serious health condition, they would have to move to the mainland anyway in order to have access to hospitals with up-to-date equipment, not to mention doctors. Even a bad cut or wound requires a chartered ambulance boat ride (albeit free) to the mainland and the nearest hospital, which, in this maritime nation, has its own pontoon for arrivals by private boat.

In addition, the government-dispatched “hospital boat” carrying a crew of nurses and doctors to do routine health checks (exams for stomach and intestinal cancer, breast exams, X-rays, etc.) would still come to serve all islanders, the way it always has. The health boat offering o-bentō boxed lunches and hot baths for the elderly would still come once a month. And caregivers would still call on certain houses twice a week.

Sitting at the town hall meeting and listening to the residents spar with local authorities, it occurred to me that the issue here was not the sanctity of readily available medical care. What these newly orphaned patients were upset about was something deeper. They hadn’t just lost their doctor, they’d also lost their friend.

Japan Lite appears in print on the fourth Monday Community Page of the month. Comments: community@japantimes.co.jp

  • DeDe Miura

    Such a touching article, Amy – thanks.

    • Helen Hernandez

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    • Helen Hernandez

      ::f312Work At Home….Special Report….Earn 18k+ per monthfew days ago new McLaren. F1 bought after earning 18,512$,,,this was my previous month’s paycheck ,and-a little over, 17k$ Last month .,3-5 h/r of work a days ..with extra open doors & weekly. paychecks.. it’s realy the easiest work I have ever Do.. I Joined This 7 months ago and now making over 87$, p/h.Learn. More right Here::f312➤➤➤➤➤ http://www.insiderexpress22.com.­nu .❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:::::::f312…….

    • Helen Hernandez

      ::f312Work At Home….Special Report….Earn 18k+ per monthfew days ago new McLaren. F1 bought after earning 18,512$,,,this was my previous month’s paycheck ,and-a little over, 17k$ Last month .,3-5 h/r of work a days ..with extra open doors & weekly. paychecks.. it’s realy the easiest work I have ever Do.. I Joined This 7 months ago and now making over 87$, p/h.Learn. More right Here::f312➤➤➤➤➤ http://www.insiderexpress22.com.­nu .❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:::::::f312…….

    • Helen Hernandez

      ::f312Work At Home….Special Report….Earn 18k+ per monthfew days ago new McLaren. F1 bought after earning 18,512$,,,this was my previous month’s paycheck ,and-a little over, 17k$ Last month .,3-5 h/r of work a days ..with extra open doors & weekly. paychecks.. it’s realy the easiest work I have ever Do.. I Joined This 7 months ago and now making over 87$, p/h.Learn. More right Here::f312➤➤➤➤➤ http://www.insiderexpress22.com.­nu .❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:::::::f312…….

    • Helen Hernandez

      ::f312Work At Home….Special Report….Earn 18k+ per monthfew days ago new McLaren. F1 bought after earning 18,512$,,,this was my previous month’s paycheck ,and-a little over, 17k$ Last month .,3-5 h/r of work a days ..with extra open doors & weekly. paychecks.. it’s realy the easiest work I have ever Do.. I Joined This 7 months ago and now making over 87$, p/h.Learn. More right Here::f312➤➤➤➤➤ http://www.insiderexpress22.com.­nu .❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:::::::f312…….

    • Helen Hernandez

      ::f312Work At Home….Special Report….Earn 18k+ per monthfew days ago new McLaren. F1 bought after earning 18,512$,,,this was my previous month’s paycheck ,and-a little over, 17k$ Last month .,3-5 h/r of work a days ..with extra open doors & weekly. paychecks.. it’s realy the easiest work I have ever Do.. I Joined This 7 months ago and now making over 87$, p/h.Learn. More right Here::f312➤➤➤➤➤ http://www.insiderexpress22.com.­nu .❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:❦2:::::::f312…….

  • treelinedstreets

    I may be wrong, but the entrance exams for medical school (accepted straight out of from high school) are/were impossibly tough. I knew someone who wanted to become a doctor and was bright, kind, had good people skills who spent years dedicated to preparing for the test but still couldn’t pass. They were basically forced to give up on their dreams and change paths and went on to do very well in business. But sometimes I wonder if Japanese society would have been better served if people like that were given more opportunities to succeed. In the US, you have multiple chances and pathways to becoming a doctor. You have four years to find your footing and discover yourself in undergrad. And then even if you don’t get accepted to a mainland medical school, you could attend an accredited school on a US territory, for example, that had better acceptance rates. You could also bide your time and try again and again. You could also make medicine a second career in your thirties or forties with enough fortitude. But in Japan, it’s one shot to get it right the first time at a very young age. The doctor shortage I’m reading about now breaks my heart knowing that Japan lost a really promising young doctor to the field of business due to the ridiculously difficult entrance exam that didn’t measure any other skill besides rote memorization.

  • Denny Pollard

    Amy I live in a rural area of Yamagata-Ken surprising the attitude here is the same with the older people, its the way it has always been and don’t try and change anything. For the past five years I have tried to understand people here and cannot, its just learned behavior I am told I have to accept.

  • PRADEEP CHATURVEDI

    THEY can recruit number of doctors and nurses from India. Anyhow the article was very touching and humane. Rapid decline in population is causing other problems in Japan. Reverse is true in India. God only knows what will happen to JAPAN in another 15 years period. It is the greatest nation in human history. They can issue VISAS for say 2-3 years to Indians in all sectors and see the country will be over-populated in 2030