do not go to the gynecologist in japan.

oct. 2, 2006

this blog is not for the feint of heart, the squeamish or those people who do not want to hear about 'women's issues'; and let me just say that i too take offense to the vague term 'women's issues', especially after today. so be warned there are details here that are not pleasant nor modest.

background: immediately before i left for japan i was told i needed to get a LEEP done. this is a procedure that is moderately frightening to get in america; it's quite simple and therefore easy to screw up. i was advised to get it done while in japan because there wasn't time for the procedure and the follow up before i left--i was handed my file and wished good luck. whether you need a LEEP is something that you find out after your annual PAP. the procedure involves scraping the cervix to remove abnormal cells that will potentially develop into cancer. scary shit, huh?

let me just start out by saying that i really wanted to get this taken care of before i came to japan because i knew there was no way it could go good. this is not because of a lack of faith in the japanese medical system-which, B-T-W, would be totally appropriate-but rather due to the fact of medical systems in foreign countries are just that, foreign. any presumption that it will be all hunky dory and the same is just silly. now, of course, i convinced myself otherwise. this self inflicted convincing led me to think that i could walk into mazda hospital and say, 'hey, can i get a LEEP over here?'. yeah, not quiite that simple. so this a rather personal matter, but if only to make the experience seem somewhat worthwhile, i will take note of the details here, for prosperity, and those other women who cannot follow the advice given in the title of this blog.

so i begin the day continuing the procrastination that i had been practicing for the last two months, by doing a couple rows on the scarf i'm knitting. i then convinced myself that i should just get up and go. so, i headed to the JR, caught my train and got off at mukainda on the sanyo line. i got a little lost, headed for the museum instead of the hospital, called carolina for directions, and eventually found my way to the hospital. the check-in was on second floor, which was momentarily confusing, and there is where the adventure began. i found the right desk, she handed me the form, i wrote my name, we figured out what to write for my birth year and then i was handed the next form. she was sweetly optimistic and thought that my confusion was based on not being able to read kanji. another very sweet women was then recruited to read the form aloud to me. and she assumed me smarter than i am, and thought i wasn't sure of my symptoms rather than having no clue as to what she was saying. when she finally realized that i am completely clueless when it comes to japanese, especially medical japanese, she walked me over to a small room, office, thing; i was then put in a cubicle-style sectioned off 'room' with a table and chairs. [advice you can take from this: just come out and say that you don't speak japanese, stop trying to pretend] a young doctor (?) was brought over and begin to speak english (yay!), but of course, because it's japan, she said that she didn't speak english and that they had no doctors that speak english. the next step was to tell me to go to the university hospital, which they then told me was closed at 11 am (it now being 10:40) i started to freak out. this was byokyu (being the type of leave from work that is a glorified sick day) that i was on this monday morning. byokyu requires documentation, if i didn't have it then i have to take nenkyu (being the paid leave or rather glorified vacation days). if i have to take nenkyu that's one less day with elena or alex or in china or any day NOT at the doctor's or school. i think the wonderful-pseudo-english-speaker saw the tears swelling in my eyes at this point (i'd like to justify these tears with exhaustion, stress, and being called 'so young!' every time my age is mentioned. somehow being called young immediately takes away all your confidence) and she called the university hospital and found that, yes, they do close at eleven, and there's no way around it. after more finagling than should have possibly been necessary, they got the doctor to agree to see me--of course this was after finding a poor receptionist to follow me around and hold my hand. and honestly her english was rusty and therefore not that much better than the original english speaker that was handed to me. my theory is, that being the low rung on the ladder, keiko (as she introduced herself to me) could be roped into baby-sitting the gaijin, who at one point attempted to invited her into the exam room.

the next fiasco was of course just waiting. here was a comfortable position, being kept waiting by the doctor. i've done this before. the underlying terror subsided for a moment. keiko had to disappear for a bit, to appease her boss, and i took a doze. keiko returned and, finally, i was called. now i didn't realize this till later, but the doctor calls the patients' names. he sits in his little office and calls them from a speaker, even though there's a nurse right there who comes and retrieves me and could easily call my name without the need for extra technology and a creepy booming voice from above. must be an authority thing. at this point my stomach was all butterflies on the way down the hall, i stepped beyond the yellow curtain into the doctor's office and my butterflies stopped: he looked like a decent human being! and once he uttered the word 'dysphasia' my butterflies dropped dead. this is the word i needed to here. he knew what i was talking about. he pointed to the acronym LEEP on my file and asked if i had had it yet, and he spoke english! sort of...better than i spoke japanese, anyways. through a mix of broken english and a little japanese he said that today we would do a biopsy. which is better than i expected, this was only one step back rather than all the way back to a PAP smear. next, i was told to go to exam room four.

i figured i'd be kept waiting there for fifteen minutes, or so; turned out not quite the same as the american gyno. firstly, i was unsure that i would get seen right away so i was very confused by the tiny changing room--even though looking back it makes perfect sense--so i tried to get keiko to follow me in. she eventually convinced me that i went in alone, 'for one person.' i then did the changing thing, and went past yet another yellow curtain. okay, so this is where i started to freak out. now i've had this procedure before, i know the story: it is uncomfortable to our modest sensibilities and it is painful. what made it bearable in the past was the nice conversation that the doctor engaged me in, to distract me. so going in this time, i knew i wouldn't get that, the language barrier being a giant chasm, but i was not expecting the separation that the exam room forces. first there was the chair. chair, not bench or table. this was not something that i really wanted to be sitting for, but i took a look and assume that it adjusts. oh, but looking. no, that was a mistake. i glanced down at the floor below the chair and there it was, blood. yeah, fresh red blood splashed on the floor. firstly, this is bad for simple sanitary reasons. second, it's blood. some one was just in that chair bleeding. i am about to be in that chair. i am about to be bleeding. i am about to run through the yellow curtain, out the door and escape this whole shitty thing. i mentally scream at my butterflies to calm down and wait for the nice nurse to help me into the chair. then the chair. *twitch* i sit down and try to not think about the lack of sanitation with only a small paper that is protecting me from where the last victim possibly infected this monstrosity. and you think stirrups are bad? try a chair that first tilts you back, to who knows how far, and then the leg supports that automatically separate. they just kept going and going. i didn't know when they were going to stop. not a good feeling when you are at your most vulnerable.

so there i am splayed like a damn pig for slaughter, and i haven't even mentioned the worst part: there was a final yellow curtain. this sucker's only purpose was to separate the top half of me from the rest of the exam room. common sense tells me that this is to protect the sensibilities of the poor japanese women who have to sit in this torture chair. if i was in a logical mood at this moment i could have focused on this and found the cultural difference interesting, but as you may remember, i am splayed like a pig ready for slaughter. i am not calm or logical. i am nervous as hell and letting my american perspective tell me that this curtain is about shame. and honestly, it is about shame, but being an american (which is a nice thing when being able to hold this perspective, in most situations) i have no shame associated with my vulva or vagina or any of my parts--and, yes, this is something that i had to work towards being raised in a phalocentric society, just like every other woman in the world. but i am quite happy with my vulva and not really that embarrassed to have a strange man looking at my parts. but what is bad is when that strange man won't look me in the eye and my poor vag is facing out into the exam room and to whoever walks by and she is a thing, not part of me. just this faulty body part that is being fiddled with by a japanese man who probably doesn't even know how to treat one right in a romantic situation. after being told to relax, ha! i was poked and prodded--the whole time watching shadows of large tools cast their shadows on my yellow privacy curtain; the soundtrack of an old black and white horror flick is playing in my mind as i sit there wincing for ten minutes. then, i am finally set free! this is, of course, after the doctor has left so there is no chance of me making eye contact with him while i am half clothed, only my little towel protecting my lost modesty.

i then re-clothe myself, silently scream in discomfort at my reflection in the changing room mirror, and i step out to find the smiling keiko is still waiting for me. we walk down the hall together and she asks at the doctor's curtain if i am supposed to come in and talk to him. we go through the barrier, i sit down, and i am told six times that i am supposed to take out the gauze at six and then am handed a slip of paper with phone numbers, 'if you have a lot of bleeding call'. not exactly what you want to hear, but step back a moment. gauze. so this is not normal, at least by american standards. one of those things that they repeat over and over is that when you have an unhappy vagina leave her alone and let her fix herself. she's a clever gal and knows what to do. so, when they told me about this gauze my first instinct was to say no fucking way am i keeping this in till six. but then there was the list of phone numbers...maybe i should just listen to this guy. who knows how much cutting he did down there. who knows how much of a mess my cervix is in now. he schedules my next visit for two weeks later, when the test results will be in, and the whole time i am still frustrated with this system of separating the exam room from the information that is important to me. after more rigamarole of copying my files and being handed my bill, keiko walks me down to the cashier and there is, of course, one more kick in the pants for me. i am charged 8500yen. this is much more than i expected, as a friend only paid 4000yen for six x-rays and two shots. i somehow suspect that japan really does have no understanding of the birds and the bees and that even in this population 'crisis' they don't subsidize for gynecological procedures as much as for others. either that or they were playing the 'let's screw the gaijin' game.

in conclusion, this is a day i desperately want to forget, and definitely one that i do not want to relive, but the alternative is using all of my nenkyu and more money than i have to go home and get it take care of there. at the very least, i get to see keiko again. [advice you can take from this: have low expectations, expect to be confused frustrated and scared; and, if at all possible, don't even go.]