Dr. Hiko: Laughter is the best medicine

Remember that funny, young Dr. Hiko that Professor Goto introduced me to on my first day? Turns out Dr. Hiko happens to be one of the funniest men I’ve ever met. Over the next few days, he came up with some priceless stuff, which I happened to jot down, pretending I was taking notes on the medical knowledge he was bestowing upon me.  As we walked through the hospital visiting his patients, everyone he encountered walked away smiling and laughing.  His joy was contagious and an admirable quality for any physician. 

Here’s a sample of Dr. Hiko’s gems:

-“I know to you foreigners, all of us Asians look the same”

-After trading pleasantries and laughs with a cute young nurse, he pointed to me, and whatever he said, sent the nurse away cracking up.  I happened to catch a word he used, something that sounded like “Aijean”.  I asked him if “aijean” means student, assuming he cracked a joke about me as his new American student.  He laughed and explained, “Oh no, Aijin doesn’t mean student! I told her you are my new mistress!”

-“The next patient we are going to see is suffering from severe liver failure and has very bad jaundice.  So he’s very yellow.  Ok, well, all of us Asians are yellow, but he’s more yellow!”

Throughout my time with Dr. Hiko, he generously included me in conversations, introduced me to patients and helped translate between us, and went out of his way to teach me.  With his perfect English skills and great sense of humor, I couldn’t have asked for a better teacher. I’ll never forget the most valuable lesson I learned from Dr. Hiko: Laughter truly is the best medicine.

Dr. Trung and My Japanese/Korean Birthday Present

Today I turned 26 in Japan. No longer do I feel entitled to constant declarations of “Happy Birthday!”s or a stack of greeting cards with cash inside.  Rather, today I was simply excited with Dr. Trung, a young visiting doctor from Vietman, handed me a present.  Inside was a small plastic plate decorated with a picture of the Trung Tien Bridge in his home town, a Barbie keychain, and a mini bottle of nail polish remover.  He apologized that his gift was stupid but he had nothing else in his apartment. I responded that as the only gift I would open on my birthday, it did not matter the contents.  But in fact the plate is beautiful and I truly needed some nail polish remover.  His concerned frown widened to a smile and he bowed deeply, pleased that he could bring me birthday joy.  And when Dr. Rachy and Dr. Jome, two Thai doctors I had met 3 hours before, insisted that they take me to lunch at a restaurant, not the cafeteria, to celebrate my birthday, I was again reminded of the genuine goodness of the human spirit. 

A birthday is not a day for presents or greetings from family and friends.  It is a day to feel blessed.  Blessed to be alive.  Blessed to have a go at this crazy, exciting, weird, a little shitty, but always amazing thing called life.   Thanks to Dr. Trung, Dr. Rachy, and Dr. Jome, I ended up having a great 26^th birthday.

Dr. Turo- How to Survive in Japan 101

After spending the afternoon rounding with Dr. Hiko, I went back to the International Student Affairs Office to get my luggage and figure out where I’d be staying for the next four weeks.   My first day at Nagoya just happened to coincide with Dr. Turo’s first day in the International Student Affairs Office.  Neither of us had a clue as to what was going on or what we were supposed to be doing in our respective positions. So Chikako San suggested what better way for both of us to figure it out than for Dr. Turo to escort me to the dormitory where I’d be staying for the month. That way I’d make it there safely and Dr. Turo would know where students stay when they come to Nagoya.  I assured that it wouldn’t be necessary; I can figure out the subway system and find the dorms by myself without a problem.  I’ve traveled all over the world in situations way more dangerous and difficult than Japan.  Plus, just that day I’d traveled all the way from Yokohama to Nagoya and found the University without a problem.  But both Chikako San and Dr. Turo resounded to my confident declaration with looks of doubt and insistence that I needed help.  Feeling a bit childish and upset about their doubts of my navigation skills, Dr. Turo helped me with my luggage and together we headed to the subway. 

Little did I know just how badly I needed Dr. Turo.  Despite my confidence, I was 100% not ready to travel in Japan alone.  He helped me get my bearings in the subway system, purchase a one month pass to use throughout my time in dorm life, and find my new home for the month.

Once at the dorms and both of us sat through an hour long “Orientation and Tour” by the head of the dorms.  Orientation included an exhaustive explanation of the complicated recycling system, including detailed drawings, samples of recyclable materials, and a signed statement of understanding.  In case that wasn’t enough, the tour included an explanation on how to properly use the toilet.  I’m not joking. Just when I wanted to start pulling my hair out at the unending minutia of this never ending orientation, the coordinator of the dorm surprised me with a question.  “Have you tried Japanese toilets?”, he asked, referring to the high-tech toilets complete with sound, odor neutralizer, and multiple types of bidets and sprayers.  My wide eyed, amazed head shake indicating no was immediately quipped, “Oh you must try them. I just love them! Feels so nice!”.  And with that mental image, it took everything in my power not to bust out laughing.

After finally finishing the tour, Dr. Turo and I had dinner together at a great little Soba shop down the street from the dorms.  He gave me my first and only lesson on proper chopstick technique and Japanese etiquette, which turns out is just about opposite of everything we’re taught in the US.  Keep your hands on the table at all times, hold the bowl up to your mouth and sweep the noodles and broth into your mouth, slurp loudly as a sign that you enjoy the flavor.  All the while, you’re barefoot and have no napkin.  His lesson turned out to be invaluable and the rest of the month I was given compliments on my chopstick skills and I felt comfortable eating with my Japanese friends and professors. 

THE Professor Goto

I’d been on campus approximately 43 minutes before I was escorted through a series of walkways, hallways, elevators, and doorways to the Department of Gastroenerology where I was told I’d be rotating for the next month.  I was quickly introduced to Professor Goto, sweet older gentleman, sitting in his office, reading some important looking journal article related to Gastroenterology, which he heads.  He stood up to greet me with a bow followed by a hand shake, a big smile on his face the entire time.  Inviting me to take a seat across the desk, I sat and listened while I excitedly told me about the many times he’s visited the United States for such and such a conference and this and that meeting.  Through his broken English and fast talking, I learn he loved San Diego (which I’ve realized many Japanese have an interesting love for San Diego).  Detroit and Chicago were nice, but both cold.  But most importantly, Professor Goto absolutely adores New Orleans.   I caught something about Tulane being a good school and that DDW is held there regularly and every time DDW is in New Orleans, Professor Goto definitely attends.  I had no idea what DDW stood for, but I smiled and nodded, pretending to understand and just glad I figured out that he likes New Orleans.  That gave me plenty to work with conversation-wise.  We chatted- well, more like he talked while I did my very best to understand and insert appropriately timed smiles, nods, and laughs- for a solid ten minutes before he decided it was time to give me a tour.  We walked room to room down the long hallway of Gastroenterology while Dr. Goto stopped to introduce me to every person we crossed.  I didn’t catch a single name or what their position was in the department, but there was lots of bowing and smiles.

We finally made it down to a room full of young looking men in white coats, and I realized I had no idea if they were students, residents, attendings, lab techs, or otherwise.  As soon as we walked in, the joking and laughter stopped and they all turned to bow and greet Dr. Goto.  By now, I started to notice a trend.  As the head of the department, I assumed he would have some prestige amongst those in Gastroenterology.  But this was different than the way folks interact with Department Chairs at Tulane.   I didn’t realize it at the time, but looking back, I now see those bows and formal greetings as deep respect with a dash fear and a pinch of absolute terror. 

Professor Goto introduced me to a young looking physician who told me his full name, quickly followed by a smile and “Don’t worry, I know Japanese names are too hard for Americans.  You can call me Hiko”.  Professor Goto, informed Dr. Hiko that I would be joining the Gastroenterology Department for one month and that he was in charge of me.  With that, Dr. Hiko nodded, smiled, bowed, and dropped what he was doing to follow us back to Professor Goto’s office. 

It wasn’t until later that day and the next few days that I slowly came to appreciate the gravity of my meeting with Professor Goto.  Little did I know at the time that I was being introduced not to just a Professor like we think of in the States.  In Japan, for each Department there is only One Professor.  THE PROFESSOR.  And what Professor says, goes. Over the next few weeks, people in the department would ask me if I’d met Professor the same way someone would ask if you’ve met a B List celebrity that lives in town.  That first day, I definitely respected the man.  But after a week in the department, I began to appreciate the fear that comes with such a rigid hierarchy.  Looking back, I’m grateful for the ignorant bliss with which I entered that office on my first day at the University.  Had I known what I know now, I would definitely be more nervous to sit and talk.  Perhaps my informality on our first meeting came across as impolite.  But perhaps The Professor appreciated the innocent causality with which we chatted.  After all, despite the title and the hierarchy and the power, The Professor is still just a regular dude that likes to party in New Orleans during DDW, which I only later figured out stands for Digestive Disease Week.  Of course.   

Chikako San: How I got to Japan

I had no idea what to expect when I finally walked into the International Student Affairs Office at Nagoya University.  The only thing I knew about my month at Nagoya was that I needed to show up at that office at noon on Monday to meet Chikako.  I’d been emailing back and forth with Chikako over the last four months to get everything in line for me to come to Nagoya.  Before I arrived, she’d helped me complete my application, booked my flights here, found me a place to stay, coordinated my rotations, and answered my million questions.  After all the help she’d give me  I was looking forward to meeting her, but nervous at the same time.  I had no idea what she’d be like in person and she was the ONLY person I “knew” in the entire country other than my Aunt Reiko.   When I knocked on the door and heard a happy “Come in!” my nerve subsided and I knew I’d found the right place.  A beautiful, fashionably dressed woman greeted me by my name then gave me a big smile and a hug.  Her English was perfect and her quick laugh reminded me of my mom.  I instantly felt comfortable and reassured that this month would turn out just fine.

After taking care of a few business items, it was time for me to start my rotation.  I thanked Chikako and gave her the Tulane coffee mug and jar of Tony Chacheres seasoning I’d brought her from home.  After warning her that the seasoning was spicy and just try a little, she laughed and reassured me that she liked spicy food and sometimes Japanese food needs a little kick to it.  With that, my vacation was over and we headed to the gastroenterology Department where I’d be rotating.  Again, my nerves started to kick in; I wasn’t sure I was ready to be an American Medical Student in Japan.  But as it turns out, when the only person you know in an entire city reminds you of your mom, everything seems a little easier.

Aunt Reiko

Two years ago my Uncle Trent moved to Yokohama, Japan to become the Principle at Saint Maur International High School.  Within the year, he had fallen in love with Japan and with a Japanese woman.  Not too long after, he had the good sense to make Reiko his wife and now my aunt.  And most recently, they had the good sense to have a baby! Reiko is about 13 weeks pregnant and a tiny baby bump is starting to peak through her tiny little frame. 

I first met Reiko two Christmases ago and immediately saw how blessed we were to have her in our family.  Shy, kind, generous, funny, hard working and incredibly intelligent, Reiko was my first glimpse into Japanese culture.    Hearing her and Uncle Trent talk about Japan, I knew I needed to see it for myself.  So what better way to start out my trip than a weekend with Reiko in Yokohama!

Ironically, Uncle Trent flew back to Seattle for a short summer vacation the same day I flew into Japan.  Most likely we crossed paths thousands of feet in the air somewhere over Alaska.  It would have been great to see Uncle Trent, but I didn’t mind having Reiko all to myself for a few days.  After a long few days of travel via planes, trains, and automobiles, I gratefully rang the doorbell at Trent and Reiko’s apartment.  After a smile and hug, Reiko took my bag while I took off my shoes and she welcomed me to their home.  I asked for a tour and she proudly showed me their apartment, most notably the wonderful balcony with a gorgeous view of Nagoya, my Uncle’s impressive baseball hat collection hung on their bedroom walls, her bookshelf full of Japanese novels and English children’s stories (through which she taught herself to read English), and the pictures hanging on the refrigerator of my baby cousin from her most recent ultrasound.

I spent the next two days exploring Yokohama with Reiko.  She and Uncle Trent had planned out two action packed days for me and Reiko went out of her way to make sure I saw the best of Yokohama.  We ate street food in Chinatown, cheered on the Yokohama Baystars in the gorgeous Yokohama stadium, meandered along the Yokohama Port, ate Ramen, and grocery shopped.  And that was all on Saturday!  By the end of the day I was happily exhausted while Reiko looked like she was just getting started.  Where she gets her energy I’ll never know.  We got back to the apartment and Reiko handed me a beer that Trent had bought for me before he left.  I took about four sips before I fell asleep on the couch. 

On Sunday Reiko cooked me a delicious “American” breakfast before we headed out to visit the beautiful town of Kamakura just outside of Yokohama.  Beautiful Buddhist temples and shrines surround Kamakura, which also happens to right on the beach.  We visited The Great Buddha and ate green tea ice cream next to the temple.  When I told her how much I love the beach, we walked down to the water so I could feel the sand between my toes. We walked through the famous Hydrangea Gardens, visited the Kamakura temple, and shopped for souvenirs. Before we headed back to Yokohama, we made a short detour to buy Taiyaki, a delicious custard filled doughnut type desserts in the shape of little fish.  They’re one of Trent’s favorites and Reiko wanted to make sure I tried them too.   In case the day wasn’t amazing enough we finished it off with Udon for dinner at Trent and Reiko’s favorite Udon restaurant, then went to the top of the Marine Tower.  Reiko told me she wanted me to see how beautiful Yokohama is at night and there’s no better spot in the city.  Undoubtedly, the view was simply breathtaking.  All in all, I couldn’t have asked for a better  weekend or a better tour guide. 

Leaving Reiko and the comfort of her loving hospitality made Monday morning, well, a pretty miserable Monday morning.  But, by my request, she made me a “Japanese” breakfast, then walked me to the subway to help me buy my Shinkansen Bullet Train ticket to Nagoya, my final destination in Japan.  I’m not sure when I’ll see Reiko again, but when I do she’ll be a mother.  If the way she treated me this weekend is any indication as to her parenting skills, that little guy/gal is one lucky baby.            

With Love from Japan

Three years ago I set out on two ambitions missions.  One: Survive and thrive in medical school.  Two, Eloquently describe this adventure of becoming a doctor through a series entertaining, engaging blog posts.  I’ve almost succeeded on the former.   And subsequent to said former, I’ve failed drastically on the latter.  Having blogged in the past, I was aware of the emotional energy and time commitment required for a blog.  Not having a freaking clue about what medical school was like, I was naively blind to how emotionally draining and time consuming the whole Making of a Doctor process would actually be. 

I’m now technically a fourth and final year medical student.  The cadaver lab, endless lectures, late night study sessions and stressful tests joyfully lingering in my past. Only a few more clinical rotations of my choosing and the residency application and interview process keeping me from the loving arms of residency, where real doctors are made. 

Had I been blogging as promised, any faithful reader (most likely only my mom, grandparents, and a few others out there who love me enough to read this) would have known the difficulty and anxiety regarding my future in medicine that I experienced during my clinical rotations. All the horror stories I’d refused to believe about medical school came true.  I became the cynical, skeptical, cranky third year student I always begrudged for hating medicine. But that story if for another time and place. I really want to tell you about what’s happening right now.  

From the skepticism about medicine, and my future in it, came my attempt to figure out what the heck I’m doing with my life.   This search has manifested itself in me taking a one year hiatus in Atlanta, Georgia working for the CDC.  But before I leave for Atlanta, I jumped on the opportunity to finish my last medical school rotation for the year at Nagoya University School of Medicine in Nagoya, Japan.  I now right to you from my 7x11 foot bedroom in the international student dorms in this crazy country called Japan.

At the urging of my friend Adam to write a blog, I remembered that ambitious mission I set out on three years ago.  I technically already have a blog, neglected as it may be. But I’m not up late studying, so why not write about my experiences in Japan? And after ten days in this country, I’ve figured out how to do it.  Japan is a place of culture, tradition, ambition, honesty, ethics, orderliness, Buddhist temples, ancient castles, bullet trains and extraordinary cuisine.  It is also a place of Manga, Sumo, American baseball, Karaoke, and beer gardens.  But most importantly, Japan is home to some of the most amazing people I’ve ever met.  This blog will be about all those ideas, places, activities that make up Japan, told through the incredible people that have share those experiences with me.