Sick in Tokyo: I Lived to Tell About Japanıs Medical Miracle
By Nicholas Kristof
the new york times

tokyo - Everybody thinks the Japanese medical system is one of the 
best in the world‹everybody except the Japanese. 
	That paradox had bothered me for some time, and I was 
searching for a way to explore Japanıs health-care system when the 
challenge resolved itself. 
	Last year, in the middle of the night, members of an ambulance 
crew barged through my front door in Tokyo, eyeing me 
apprehensively, checking their masks and rubber gloves, preparing to 
cart me off to the hospital. 
	I had just returned from the central African jungle, and that 
day I felt an ache in my joints. By nightfall I had a fever of 104 
degrees. I was pretty sure I had malaria, and so I called a colleague 
for suggestions. 
	My colleague had called emergency services, which 
immediately dispatched an ambulance team with suits and masks.
	One advantage of Japanese ambulances, I discovered, is that 
they are free. In fact, the Japanese think Americans have incredible 
gall to charge for taking someone to the hospital in an emergency. 
But the downside is that the ambulance crews do not have much 
training or equipment and are in the business of transport rather 
than treatment. 
	The doctors at Hiroo Hospital had never encountered a 
potential malaria patient before, so they established that I would 
survive the night and politely asked me to come back in the morning. 
	The next morning I waded through the hospital bureaucracy and 
sat about in lines. It is usually impossible to make an appointment 
to see a doctor in Japan, so the custom is to go to the doctorıs office 
and wait. And wait. 
	In my case, I got to see a physician in 45 minutes. He asked 
about my symptoms, scowled, consulted a book, and said: ³Weıre very 
busy today...come back in two days for a blood test and physical 
exam.²
	³But if Iıve got malaria, I need a blood test immediately,² I 
said. ³People can die very quickly.²
	The doctor looked grumpy. He looked down at his textbook, 
startled at a patient who talked back. Japanese doctors are famous 
for never telling patients anything, particularly bad news. 
	In my case, after spending 20 minutes with me, insisting to me 
that I did not have malaria and could not be tested for another two 
days, the doctor evicted me and the nurse gave me the bill. Eight 
dollars. 
	In the meantime, my office had located Japanıs leading 
specialist on malaria. He instructed me to come over immediately 
for a blood test, and quickly announced that I had falciparum 
malaria, the most lethal kind. 
	I took a hospital bed with a fellow who coughed and spit and 
moaned all night on one side, and a snorer on the other. 
	I soon learned that the drugs normally used to treat malaria 
were banned by the powerful Health and Welfare Ministry.
	The standard treatment for my kind of malaria is a medicine 
called mefloquine, available most everywhere except Japan. 
Fortunately, my doctor had his own private supply, apparently for 
experimental purposes. 
	The hospitals are run by cheapskates. When I tried to get a 
drink, the nurse explained that I must supply my own cup. And 
chopsticks. And soap.
	I was released after five days.  The best surprise was the bill, 
which came to less than $1,000. Ultimately I was treated as well as 
I would have been in the US‹for a fraction of the cost. I came to see 
Japanıs medical system not as a new Mercedes but an old 
Volkswagen: a ³peopleıs car² that is cranky and slow but gets you 
where you want to go. 
	When American friends ask me where they can stay cheaply in 
Tokyo, I tell them the hospital. Just bring your own soap.