Monday, January 28, 2008

Standard of Care

About a month ago I expressed my discontent at the way the emergency orthopedic surgeon in Kagoshima handled my injury back on December 18th. This was based mainly on:

1. My limited knowledge of relevant medical Japanese
2. Fury at myself for having the accident in the first place
3. Pain as I felt the bone pressing on the nerve

During a follow-up in the US, I discovered another surgeon would not have treated the fracture in the same manner (granted, he did not have the initial x-rays or as much information about the accident). As such, I felt the entire Japanese medical experience could have gone better.

As I was sitting in recovery from this past (and hopefully last) surgery, I had the chance to review the file from my initial visit. It turns out… they did as thorough a job as anyone would expect, taking X-rays, CT scans (cross sections of the hand and wrist), culminating with a 3D imaging display of the damaged bone.

The staff were knowledgeable. The surgery was done properly. Although I was in no intellectual condition to choose my treatment, given the choice now, I probably would have opted for the same conservative treatment (closed reduction over surgery) and waited to see where the cards fell.

However, I am still rather annoyed. Why? Because I wasn’t given the choice. It’s one thing to tell a person bleeding from his chest “let us take care of it, we know best” in an emergency situation, it’s quite another to not consult with a fully conscious healthy young individual in no immediate danger about his options. This type of injury, a distal radius fracture, should consider the needs of the patient before the injury; practically all doctors are in consensus on this point. And yet, because it was deemed I was either unable to understand the different courses due to the language barrier or my own foreign stupidity, I wasn’t given a second choice.

The language barrier? Understandable to ignore an unintelligible person, especially in an emergency. But I had my accident at 9:00 AM and wasn’t treated until 4-5 PM, with my bilingual boss standing guard: no one mentioned anything to him, nor apparently thought about bringing in a medical interpreter.

In all likelihood, this isn’t even really a case of cultural differences, but rather doctors in any country believing themselves to be gods, having total control over life, death, and pain while you’re in their grasp.

Knowledge is power. If your condition can wait for a few hours, call a trusted friend and ask them to do some research, or better yet, be prepared for anything…


Useful Medical Japanese

Itami ga dou desu ka?
痛みがどうですか?
How is the pain?

Nibui/sasuyouna itami
にぶい/刺すような痛み
Dull/sharp pain

Karada ga daruii
身体がだるい
My body feels heavy

Shokuyoku ga nai
食欲がない
I have no appetite

Samuke ga suru
寒気がする
I have chills

hakike ga suru
吐き気がする
I feel nauseous

Memai ga suru
めまいがする
I feel dizzy

Mune ga kurushii
胸が苦しい
My chest feels tight

Ikigire
息切れ
I’m short of breath

Rentogen no shashin wa mite mo ii desu ka??
レントゲンの写真わ見てもういいですか?
Can I see my x-rays?

Kafunsho
花粉しょ
Hay fever

Shujutsu
手術
Surgery

Isha
医者
Doctor (or sensei)

Kangoshi
看護し
Nurse

Gairai
外来
Outpatient

Kyokubumasui
局部麻酔
Local anesthesia

Zenshimasui
全身麻酔
General anesthesia

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