Episode three, in which our heroes face many hardships

So we filed the paperwork for national health insurance on Tuesday and our insurance cards, including the supplemental children’s insurance cards, arrived like clockwork two days later. It’s good to be covered, but we hoped we wouldn’t have to use them anytime soon…

In retrospect, we should have guessed that someone would get sick fairly early into the trip. The trip itself was exhausting and we were of course all jet-lagged. And although everything was new and exciting, a break in familiar habits and diet can always have an impact on health. On my study abroad trips, I inevitably have a student or two get sick early on in the trip, though it’s rarely bad enough that we need to sick medical attention. So let’s just say my skills at navigating the Japanese health care system are a bit rusty. And it really does take a good bit of familiarity with the system in order to make things work the way they are supposed to.

First, because of the national health insurance, people go to the hospital for almost everything, including the common cold. You can buy some drugs at the drug store without a prescription, but they are pretty minimal and they cost a lot more since they aren’t supplemented by insurance. So of course people go get checked out at the hospital for even small illnesses and if by some chance it’s something more serious, well, it’s a good thing they got checked out. This is a feature, not a bug, of the system. Of course, we self-medicating Americans aren’t used to this, so when Jocelyn had a fever on Friday morning, she just took some of the ibuprofen we had brought with us and went back to bad. When the ibuprofen wore off and the next dose didn’t have any effect, I visited the drug store to see if I could buy some Tylenol, where the pharmacist on duty said they had some, but we should really go visit the hospital instead, just in case it was the flu or something. Silly pharmacist, thinking he knew best what kind of medical care we self-reliant Americans needed. Visit the hospital for a little fever? Ha! So instead we tried some of the acetaminophen-based cold medicine we’d brought with us, and that brought the fever down so that Jocelyn could sleep. Surely that’s all she needs…

That wasn’t all she needed. The fever kept coming back, along with a splitting headache, aches all over her body, some nausea during the night… finally we decided that going to the hospital might not be such a bad idea around midday on Saturday. Because we were without a car, we called our landlord and the son gave us a ride to the hospital. Of course by now it was outside regular consultation hours, so we had to go the emergency room, something we medical-bill-fearing Americans would usually avoid like the plague… unless we actually had the plague. It turns out Jocelyn did have the plague, or at least its modern equivalent: the flu. Influenza is pretty widespread in Japan right now, we learned, so it would really be a good idea to come in and get checked out as soon as possible when symptoms arise. And why the hell weren’t we all wearing masks?

On the streets and in the trains, you see a lot of people wearing surgical masks as a matter of course. Some of them are sick and don’t want to infect others. Some of them don’t want you to infect them. And some of them just find them terribly comfortable and think everyone will be wearing them in the future.

So the doctor gave us all masks (which Mikki flatly refused to wear, resulting in a protracted argument in the hospital parking lot) and prescribed Jocelyn drugs: five days of flu medicine and separate drugs to treat her fever, pain, and nausea. Total cost of visit and medication: around $35. Jocelyn would still be contagious for a few days, though, so we just hoped that none of us would catch it from her…

No such luck. Eli had a minor cough in the morning but no other symptoms, so we sent them off to school as usual. Then around midday I received a call from Eli’s teacher saying he was achy and running a fever. Damn! I told the teacher I’d be there in ten minutes to pick him up, grabbed the kid’s insurance cards, and hopped on the bicycle to go pick him up. At least the hospital where we had taken Jocelyn wasn’t far from the kids’ school, and I had just been there two days earlier so I knew the ropes. Finally something would be easy…

Once again, it seems that I had forgotten everything I once knew about navigating the Japanese health care system. Hospitals have set, rather limited hours for open consultation and the rest is set aside for appointments. By the time I picked Eli up and walked him on the bike to the hospital, those hours were over. Instead, they could recommend a nearby clinic. Japan has a lot of small clinics, each dedicated to a specific kind of medicine. So if you have an eye problem you head to the eye clinic, and if you have an illness you head to internal medicine. And, of course, they all take the national health insurance, so no worries. Except that each of them has different consultation hours that you need to know before you go or you could end up just missing them or waiting hours for them to open. I was happy to have a recommendation from the hospital…

It turned out to be a terrible recommendation. I described Eli’s problem and they decided an internal medicine clinic would be best for him. They even did a search on the computer for which ones in the area would be open at that time and made a copy of the directions and hours for me. How considerate! Except it turned out to be a surgical clinic. Luckily I noticed this and gave them a call first. It turns out they do have one internal medicine consultant on staff, but he doesn’t come in until 5pm. Okay. I went back to the consultants at the hospital and described the problem and they found another clinic for me though it was, they said apologetically, “a bit far away.” Still, better a far away clinic that was open than a nearby one that was closed, right? So we grabbed a cab and went there… where we were told that they didn’t treat children. I would need to go to a pediatric clinic. Of course I would! I’m sure I would have figured that out myself if I’d tried. But instead I just took the hospital’s recommendation, figuring they knew best. I was so frustrated, and Eli was completely exhausted and feverish and just wanted to rest while I kept dragging him around to different places. This was definitely the low point. The clinic gave me a list of other clinics in the area, including two pediatric clinics, but they warned me that most pediatric clinics don’t have consultation hours until late in the afternoon, after kids are out of school. Plus, since this clinic was “a bit far away” from where we lived so were all the other clinics they recommended. So instead we just grabbed another cab and went home, where I could let Eli rest and where I had the resources to look for another pediatric clinic closer to home.

Eli went to bed and I hopped on the computer to look for a pediatric clinic, finding one just a ten-minute walk away that also started seeing children at 3pm rather than 5pm like most of the others. Eli was asleep by this point and I would normally have just wanted to let him rest, but since Jocelyn had the flu I felt more urgency at getting him to be seen. Jocelyn had brought Mikki home from school by this point, so I went and got us a cab and all four of us headed to the clinic.

Finally THIS was the medical experience we’d been looking for. There was a separate section to sit for kids with fevers and we set Eli there while I checked him in and started taking his temperature. Since Jocelyn and Eli both had it, we decided to take Mikki’s temperature too, just in case… and we immediately moved her over to the “fever zone” as well. Both kids got tested for the flu and, although Mikki’s test was inconclusive, given the circumstances the doctor decided to prescribe her flu medication as well. The pharmacy was right across the street and we were able to pick up their medication in just a few minutes. And, as they had said at the city office, the kids’ visit was only $5 per child, including medicine! In the end the most expensive thing about the experience was the cab fare. And now we have a children’s clinic we trust just ten minutes away. The end of the day felt a lot better than the middle had.

It’s now five days later and the kids took the last dose of their medicine this morning. They are now officially flu-free and can head back to school on Monday, which is a good thing since we’re all going a bit stir crazy. I think we’re all tired of our lives being on hold, and we are eager to get on to a schedule. But for now it’s the weekend and we’re going to head out to do something fun. More later.