Every person regardless of nationality over twenty years old residing in Japan is required to be enrolled in a:
1. Health insurance program
2. Pension fund program
Employee’s Health Insurance (健康保険)
Back to basics: the insurance system in Japan, depending on the size of the company in which you’re currently employed, falls into two categories. If you’re with a company that employs more than five people, you must pay under the Social Insurance system (shakai hoken, 社会保険).
Under the Social Insurance system, we have:
1. Employee health insurance (kenkou hoken, 健康保険)
2. Employee pension (kousei nenkin, 厚生年金)
Social Insurance, health insurance
Social Insurance, pension
Eikaiwa employees and those teaching English in Japan
Be careful what you sign up for. I know if you’re first coming to Japan, you’re busy settling things at home, getting the visa paperwork taken care of, and learning about the job and country, but pay attention to the fine print
Last year, AEON gave its employees an option: continue working 29.5 hours/week and accept the fact you have minimal emergency insurance, or convert your contract to a 36-hour working week and pay into the shakai hoken health insurance and pension system.
I came into AEON and Japan in complete ignorance about the health care system. Complete – unknowing, uncaring. After all, I’m immortal, aren’t I?
For some years, AEON had its employees working 29.5 hours a week. Why not round up to thirty? Because they didn’t want the extra charges of paying into the employee insurance system:
“According to the Health Insurance Law and Employees’ Pension Law, companies must enroll all workers who work more than 30 hours a week and who have been in Japan for over two months in both the health insurance and pension systems. No exceptions.”
Under the shakai hoken, you pay 50% of all premium costs monthly, and the company pays the other half. By keeping employees on a reduced workweek, AEON was sneakily avoiding its responsibilities to both the government, and the working foreign “teachers”. As I mentioned in my “The Truth About AEON” posts, management was willfully ignorant of just how corporate headquarters chose to circumvent the law
…working hours. 29.5. Why? Because, according to Japanese law, if you work over 30 hours you are a full-time worker, and entitled to full-time benefits (and on the reverse, different taxes, of course). Still, management just stared me in the face when I explained this to them.
“According to Japanese law, I am a part-time worker.”
“No, you are not. You are full time teacher.”
“No, not according to the law.”
“Why are you saying this?”
Because it’s important for all parties to understand that. No amount of insistence or stubbornness will change that fact. And if I am a part time worker, I should not be coerced into working extra hours unless you want to face the consequences of employing me as a full-time worker.
Other part-time workers in Japan have had it much worse; everyone knows unpaid overtime is as natural as having black hair in Japan. Some were working 40-50 hour/weeks while still under a part-time contract. No health insurance. Part-time wages. No assistance for childcare. There have been some attempts to improve this, but I believe it’s still rather rampant.
What does the kenkou hoken cover?
– 70% of all medical costs
– 60% of salary from lost days (beginning from the third day absent from work due to injury or sickness)
– High-cost medical expenses cannot exceed about 80,100 yen/month
– 0% interest loans are available
Social Pension (kousei nenkin, 厚生年金)
If you’re not planning to stay in Japan long-term
dattai ichijikin, 大体一時金
You can choose to withdrawal a portion of the pension you have paid into, proportional to the amount of time you have spent in Japan (see details here, under “Lump-sum Withdrawal Payments”). To qualify, you must have lived in Japan and paid into the pension for at least six months; the return must be filed within two years of your departure from Japan. The application form (only applicable for foreign residents of Japan) is here
“You can file for a refund of up to 90% of your contributions provided you’ve been contributing for over 6 months but stay in Japan for less than 3 years.”
The refund is calculated by taking your average monthly remuneration over the time you paid into the pension and multiplying it by the benefit rate:
Benefit = Average standard remuneration (monthly salary bracket) x Benefit multiplier
If your final month paid in the employee pension fund is between September 2007 and August 2008, and you have lived in Japan for (benefit multipliers):
6-11 months – multiply by 0.4
12-17 months – multiply by 0.9
18-23 months – multiply by 1.3
24-29 months – multiply by 1.8
30-35 months – multiply by 2.2
36+ months – multiply by 2.6
A refundable 20% withholding tax will be deducted from this total. The tax can be recovered however, minus a fee, by signing up with a tax agent before you leave Japan.
Health and Pension in Japan
City of Tochigi Guide to Social Insurance
National Health Insurance (国民健康保険)
kokumin kenkou hoken
If you are self-employed, in a company that employs fewer than five people, or in a different situation entirely (unemployed, student, retired, long-term traveler, etc) you might consider signing up for the National Health Insurance system of Japan; there are alternatives – see “Insurance through Private Companies” below.
Under the National Insurance system, we have:
1. National health insurance (kokumin kenkou hoken, 国民健康保険)
2. National pension (kokumin nenkin, 国民年金)
National health insurance
What does the kokumin kenkou hoken cover?
Practically the same benefits as the shakai hoken system, with the exception of:
– Not being paid for lost time at work (if employed at a company)
– A smaller cut-off for high monthly medical expenses (i.e. you pay more)
Unlike the shakai hoken, the National Insurance System premiums (monthly payments) are based on your previous year’s salary.
Thus, if you are new to Japan, the government does not consider your employment status from the previous year, and you pay the monthly minimum. If you choose to stay a second year, you may notice your paychecks will be substantial smaller, due to the national system now having some data on your salary.
If you stay in Japan without paying into any insurance system, and then try to register with the kokumin kenkou hoken, you will have to pay retroactive from the moment you entered the country. It is illegal to be a resident of Japan without having some kind of health insurance and a pension.
If you’re not planning to stay in Japan long-term
The same procedure can be used to get a lump-sum withdrawal of the money you’ve paid into the pension (dattai ichijikin, 大体一時金). However, it’s calculated differently:
Time in Japan
6 – 12 months, ¥41,580
12 – 18 months, ¥83,160
18 – 24 months, ¥124,740
24 – 30 months, ¥166,320
30 – 36 months, ¥207,900
36 months or more, ¥249,480
No withholding tax is taken from the national pension withdrawal.
“The National Health Insurance is managed by ward offices in big cities and by small town government offices. Although it is a “national” insurance, each municipality is receiving funds and paying the claims. They are like a group of small insurance companies. They are all in the red. Some are just redder than others. As a result, insurance rates vary from one city to another. Even Japanese feel cheated by this disparity.”
This website goes on to point out how easy it is to be trapped in the National Insurance system; if you’re leaving the country, it’s generally not a problem, but once you’re signed up, it can be difficult to switch to a private company. Some have tried moving without forwarding their address to the insurance, leaving Japan on paper, or just presenting the proper paperwork and taking their chances:
Labor Insurnace (Worker’s Comp, 労災保険)
This is a compulsory insurance that employers are required to provide. It covers injury, sickness, disability, and death related to work, whether at the company or while commuting.
What does the rousai hoken cover?
– 70% of most medical costs (and 100% of some)
– 60% salary paid for lost days (beginning from the third day absent from work due to injury or illness)
– Disability, graded according to the injury
Labor Insurance Information (English)
Labor Insurance Information (日本語)
Insurance through Private Companies
Although employees are required to register with the shakai hoken as per their working contracts, those working freelance or at smaller companies do not necessarily have to pay into the National Health Insurance plan (kokumin kenkou hoken).
– If you are currently paying into the shakai hoken, you can choose to supplement this (and avoiding paying the 30% in the event of injury) by signing with a private company
– If you aren’t signed up for the National Health Insurance plan yet (supposed to do it as soon as you receive your gaijin card), it is possible to sign on to a private company, present proof of insurance to the government, and they should stop hounding you to enroll in their plan. However, once you are in the national insurance system, I’ve been told it can be rather difficult to escape; read some of the controversy at National Health Insurance Watch
One of the private insurance companies serving Japan is AFLAC
– AEON employees are all now on the Social Insurance system (shakai hoken, 社会保険)
– Teachers with the JET Programme are on the Social Insurance system
ryouyouhi shikyuu shinseisho
Application for Medical Expenses
shobyou teatekin shikyuu shinseisho
Application for Sickness and Injury Allowance
Name of injury or sickness
Was the injury the result of someone else’s actions?
Describe the circumstances that led to the injury or disease (when, where, why)
Name and address of treating physician
Period of receiving medical care
Period of hospitalization and medical care
Commuting to hospital
During your time in the hospital, how much did you pay for medical care?
Social Insurance Agency
– The official website, listing all details of employee insurance and national insurance, and links to some of the paperwork (日本語で
National Health Insurance Watch
– Controversy surrounding the National Health Insurance system of Japan; some good examples
The General Union Interac Branch
– A review of your rights in Japan concerning health insurance and pensions
City of Yokohama Services
– Detailed information about the National Health Insurance Plan
– Very useful guide for all situations, including medical and insurance issues, in all languages
Legal Counseling for Foreigners
– List of legal counseling services for foreigners in Japan; on the phone and in person, pro-bono and charged
AMDA International Medical Information Center
– A good page covering the general procedures for medical care; there are links to insurance information, but the regulations are a little dated
Health Forum on Gaijinpot
In Case of an Emergency
Call 119 for an ambulance. Don’t forget to take your Health Insurance Certificate with you.
On your first day at a new company, you will be paraded around like the newbie you are and expected to give formal introductions to the department chair, upper management, perhaps even the CEO. If your place of business holds regular group meetings, you might be asked to give a short introductory speech. Give everyone your undivided attention during these introductions, as they will be giving you theirs.
宴会 (enkai) – afterhours parties with coworkers; depending on the business, these can be regular events. Even though you are “off the clock”, keep in mind people still talk shop while at parties. In fact, it’s a better opportunity to make requests and provide criticism, as you should be drinking and formal language and behavior aren’t expected (even if no one is drunk, it’s assumed the behavior can be excused as such).
9. Breaks and Vacations, yasumi
Short breaks are easily tolerated, but you might find that smoking breaks are much more common (percentage-wise, more teenagers smoke in Japan than the US) and sociable… if you happen to たばこを吸います (inhale tabacco). I myself do not indulge, but I also miss out on shooting the breeze with coworkers from adjacent offices.
Employees are given at least ten days of paid vacation for their first year with a new company, in addition to the national holidays of Obon in August and Shogatsu in January. To be considered a model employee, you shouldn’t use all those days. Generally speaking, you should use about half. However, some managers are amenable (if your manager takes all his vacation time, chances are you can too).
8. Key phrases
おはようございます – Good morning
お疲れ様です – Said during the day to passing co-workers; encouragement to work hard
行って来ます – When going out for lunch or an extended period
ただいま – When returning
ちょっと行って来ます – When going out for a few minutes only
お先に – “Excuse me for going first”; there are many instances of this being used, but a common example would be leaving the table before someone finishes his meal. If you do finish together, try to stand up at the same time.
お先にしつれします – Said when leaving the office early (お先に is also ok, if you’re being casual)
Unlike many American and western companies, Japanese businesses, even large ones, do not necessarily hire cleaning crews; even if they do, the janitors might just handle the larger jobs (bathrooms, kitchens). As a result, you will probably be asked to join in with your fellow workers one morning or afternoon a week and sweep, vaccuum, dust, wipe, and empty the trash.
6. Aftertime, zangyou
Aftertime, not overtime; although this type of behavior is slowly being changed, it’s still expected of many Japanese workers. Your contract says 8:30-5:30? Well, you can come in at 8:29:59 without a hitch, but to be seen as a model worker you should stay until 6:30 or 7:00… perhaps later. Don’t leave before your boss. It doesn’t matter if you’re doing anything productive or not, just the appearance of doing work is necessary. If you do leave before anyone else, be sure to bid them お先に (osaki ni).
Naturally, this is starting to change in Japan as many people are starting to realize what a huge waste of time it is (statistics showing Japan was not very productive); even working mothers were and still are frowned upon for leaving work to give themselves enough time to meet their children at home.
5. Language Skills
“…becoming fluent in Japanese can be a double-edged sword. While in some situations it is either necessary or extremely useful to be good at the language, I occasionally noticed colleagues who felt uncomfortable with a foreigner speaking their language. They didn’t quite know whether I should be treated as a local or as an outsider. A Westerner who speaks and reads fluently is sometimes treated as an oddity – like a talking robot: amazing, but does it really understand what it is saying?
What surprised me was how attitudes in the company changed as I gained fluency. When I was at the beginner level, people often praised my stumbling efforts, but as I got better the praise stopped. It was as if I was trespassing into some off-limits territory where I didn’t belong. Many highly educated Japanese are proud of the fact that they can communicate with a foreigner in his or her language and feel slightly disappointed when that ability is made redundant.
When a foreigner has some professional expertise, he (assuming a male in this case) may be more highly regarded and receive better treatment if he speaks little or no Japanese. On the other hand, if he is fluent the issue becomes more complicated. After generating some initial surprise and perhaps admiration, he may find himself compared with Japanese peers more easily and may be found wanting; to older Japanese, who believe a foreigner should behave like a foreigner, he may appear to be getting uppity; some people may assume that greater abilities in the language imply reduced abilities in specialist expertise; and an outside who speaks fluent Japanese will surely have lost some of that foreign cachet by going native, linguistically speaking. It might be compared to a French cordon bleu chef who arrives to work in England. Having a strong French accent and displaying French body language would emphasize his French-ness and might make him more highly regarded. If, however, after a few years he picks up the local ways and begins to speak and act like an Englishman, his perceived professional value may go down a few notches, even though he might be a better chef.”
The Blue-Eyed Salaryman, Niall Murtagh
4. Paying Attention
The level of genkiness (energy) in any workplace is variable. However, many bosses will take it for granted that you, just as any other worker in Japan, should respond with a loud, clear, “hai!” when addressed.
When a boss, superior, or even a coworker is speaking for a long time, it’s better to say something rather than just nodding or looking straight ahead. Filler words show you are paying attention and understand what is being conveyed: “hai…sosososo…eee…”, はい…そそそ…ええ…
Don’t sign any contract in Japan you don’t plan on finishing. Legally, there may not be any recourse if you choose to break it, but it reflects badly on you, reflects badly on human resources for finding you, and definitely makes your manager’s life difficult for supporting and training you all this time, just to amount to nothing.
Long-term commitment. Even with an initial 3-month or one-year contract, state your intentions beforehand. It’s better they know you whether you plan to live in Japan for the rest of your life, for the next five years, or until the end of the week.
Starting at a new company you will be asked to go to a doctor for a complete medical examination – EKG, blood tests, physical, x-ray, blood pressure, hearing, vision, urine, etc. The same can be expected every six months or so into your contract.
1. Business Cards, meishi
Business cards are the insulin, and everyone is diabetic: keep a few on you at all times. To be exchanged when meeting someone new, even casually. These cards contain the information equivalent to a resume. Receive one with both hands and read it before putting it carefully aware, unfolded. Offer yours length-wise with both hands and a short bow.
As I was in Tokyo this past weekend to observe the marathon, I found myself going through the ultimate cliché for a foreigner in Japan: having a drink at the New York Bar on the top floor of the Park Hyatt Hotel and waiting for Scarlett Johansson to look at me longingly.
Despite the appeal due to Lost in Translation, it is a nice classy joint to enjoy a drink, sample some $30 snacks, and stare at the skyline.
On this particular night, however, I was just about to take off; I had ordered a beverage far beyond my years in maturity, and had given the waiter enough to do by practicing his English and refilling the complimentary bowl of assorted nuts three times. With even the lights of Shinjuku beginning to wane from the northern view, and Scarlett nowhere to be seen, it seemed like a good idea to call it a night.
It was at that point that a guy about my age was ushered in and found himself a seat to my left. Wanting to be a good neighbor, I struck up a conversation.
Coincidences of coincidences: he was from Austin. Rather, he split his time between Canada and Austin, but I loved the fact that I actually ran into someone from Texas, in the Tokyo Park Hyatt of all places.
We get to talking about Japan and the quality of life here, and he poses a question that makes me carefully consider the answer: What is dating like in Japan?
Interesting… I try to be fair. It’s difficult, I say. And why?
1. Some Japanese girls are unashamedly attracted to foreigners (yes, some are, critics), and to such a strange degree that it makes me feel uncomfortable. After all, from my perspective, they’re not interested in me, just my green eyes, tall stature, and light brown hair. Furthermore, how can you form a serious relationship with someone like that, if you know they’re just targeting foreigners, without consideration to anything else? They don’t even care if you speak Japanese, so long as you’re willing to play their games. If you want, I can point you towards two girls like around the clubs in Hiroshima, as well as two in Kagoshima; I’m sure they’re still there doing their thing – it’s hard to stay unnoticed when you like to hang off the arm of a different gaijin (this time, it’s appropriate) every weekend.
2. On the reverse, many normal Japanese girls believe all foreign men are only after sex, and have no intention of ever forming a serious relationship with them, let alone marrying them. There are some that do this (see below, “Charisma Men”), and muddy the waters for all of us seeking something more. Of course, many people are open-minded, but it’s one more hurdle to get across.
3. If you’re considering dating another foreigner over here, there are any number of things that can happen: many people come over, leaving significant others waiting back home; many only intend to stay a year or two, and don’t want to find anyone; many are so overwhelmed with living in Japan and adapting to life here that they simply can’t handle a relationship or even dating; after living so long in Japan and slowly meshing with Japanese culture, one finds that your personality may not be the same western one you used to know, may not be one compatible with foreigners anymore (by the same token, being saturated with charisma from the Japanese dating scene).
The main reason I’m not dating any Japanese girl right now is because I know I can’t come across as anything other than a charisma man with my broken Japanese sentences and half-hearted attempts at cultured conversation in a foreign tongue. As a result, I’d only feel comfortable seeing someone who could speak fluent English with me, so there wouldn’t be any confusion as to each of our intentions and feelings. Naturally, this is only temporary until my JLP rises, but it significantly reduces the eligibility pool. If I wanted to just act like a gaijin, I could head up to Fukuoka, barge into the nearest nomihodai club, drink until someone starts to look attractive, and whisper five words of lighthearted Japanese (do you like Japan? Are you tired? Do you want to dance? Can I buy you a drink?) until her foreigner interest was peaked… shallow foreigner, shallow Japanese. Charisma men and gaijin magnets. Thoughts?
Other websites dealing with dating in Japan
Although the Japan Meteorological Agency hasn’t posted its predictions of the 2008 桜前線 (sakura zensen), I did find a useful site keeping records of all the peak blooming dates for most Japanese cities for the past ten years:
…you forget there are such things as Nozomi super express trains
…your schedule includes a 3 AM visit to Hakata for some fresh yatai ramen
…you travel to a sento in Tokyo and think, “how can they keep the water this cold?”
…a five-kilo daikon looks on the small side
…you wonder what that white powdery stuff is that tends to make a rare appearance in January
…you can actually understand Kagoshima-ben
…you travel more by car and bus than by train
…you’ve had to avoid hitting a macaque with your bike
…the only Mt. Fuji you’re aware of is Satsuma Fuji
…you have space to move around in your home
…taking a ship to a small island getaway is a day trip
…everyone you talk to in eastern Honshu wants to trade places with you
…you witness an outdoor Japanese wedding ceremony
…you can’t eat anything without first garnishing it with Satsuma Imo
…you think nothing of it when a taxi driver rounds the fare down
…He thinks we will get a few partners, maybe a few big companies with lots of potential with lots of potential, certainly more potential than that little Finnish outfit with the funny name – what was it called?
…Soon we have group of foreign companies and universities who want to join our project – IBM France, Cambridge University, the Fraunhofer Institute in Stuttgart, and some Finnish, Swiss and North American companies. We didn’t get Siemens and Philips after all, and we just didn’t click with that Finnish outfit, Nokia, who think they’ll succeed in the communications business. Fat chance they’ll have against the big boys like us in Mitsubishi.
…you have been in Japan for a long time. Perhaps you forget your English.
Somehow I resisted the urge to clobber him with the biggest Oxford English Dictionary I could find.
The Blue-Eyed Salaryman, Niall Murtagh
Niall Murtagh’s website
What does it take to be a runner? What does it take to run a marathon? You know all the people on the sidelines during races, yelling things like “go faster!” or every runner’s personal favorite, “pick it up!”? They only see the present. Yeah, at some level they know that you’ve obviously put some work into the race itself but just how much doesn’t exactly cross their minds; all they want to see is a show: a sudden burst of acceleration, an all-out war between two finishers, but the training itself… As John L. Parker put it, the Miles of Trials, or the Trial of Miles. Putting in the distance. Going day after day, raising the mileage, pushing your limits, and running not for the fun of it, but running to die. Being prepared to sap every last bit of strength that your body is capable of releasing, and using that to put one foot in front of the other.
“‘The marathon is a race of attrition.’ You’ve got to understand that. You’ve got to come to grips with that… No one really wins a marathon. You just survive it better.”
Unfortunately, no one can understand this until he or she actually goes through with it. Once a runner, always a runner. Once you get that kind of exercise pumping the blood through your veins, you find stopping or even slowing down is like amputating a part of yourself: the stamina and the speed are necessary things, as commonplace as eating and sleeping.
“Runners are much more in tune with the winding-down process… your average citizen these days isn’t that connected to the physical realm. Builders, farmers… In an older time, with say manual agriculture or hunting-gathering, you always knew how much less you could carry than a year ago. Or how much less you could ride or walk. Believe me, when dinner depends on running game to ground, you notice pretty quick when it starts to get harder… It happens with all athletes, but with us, with the endurance sports, everything is just too damned quantifiable… Modern civilian though, things happen too slowly to notice. Jeeminy, when did the basement steps get me wheezing? Am I old or just out of shape? And if you were never in shape, is there any difference?”
It wasn’t exactly the same in high school; yes, I was a runner then in cross country and long distance track, but I wasn’t really in tune with the life: my metabolism was slow, my frame was weak, and I tended to see more of the negatives than the positives (let’s face it, the cheerleaders tend to go to the football players rather than the track team).
Training for the Austin Freelance Marathon in 2005, however, I think I truly started understanding what it meant to be a runner. In a city like Austin, with a 10-mile trail jogging path being shadowed by the downtown skyline, running is life. I had a training group, a girlfriend who made me more aware of just how many miles I was putting in, and a goal: a three-hour marathon. My metabolism would forever be altered since that 30K in Buda, Texas at 2:05:53.
“…it’s the fever. That’s the thing. The fever that connects you to lovers and poets and rare-air mountain climbers and madmen and lost tribes.
…which is why, after all my experience, all my races, everything in my lifestyle… it was torture to be in the 2008 Tokyo Marathon and unable to cut loose due an injury.
Participants began arriving in droves from all corners of the world, making their way east of Shinjuku Station in the northwest region of Tokyo. Runners, one and all; lining the underground passageways beneath the Tokyo Metropolitan Government Building, cascading across the streets above. 31,000 men and women, running to run, some running to win.
That day I was merely a civilian, camera in hand, my distinction marked only by my BIB section placement: I was a B, the second fastest group in the race. Though we were capable of matching wits with the A’s, endurance always wins out over speed. How to survive it better…
It was all coming back to me in a rush; at least in Kagoshima, I rarely see the competitive edge among recreational joggers and local 10Kers. But here, in the heart of Japan, we have some true 走者. Cutting through the cold air of the early morning when most choose to sleep. Stretching as a necessity for the long race ahead. Cramming in protein and double-checking the supply of energy packs and water. Striding out 100 meters and returning with smooth, fluid motion.
Although ordinary athletes and civilians complain about the distance involved, I had never been more tempted in my life to just cut loose, shatter my healing wrist, and at least try to run 26.2 miles to prove my worth. As it was, all I received were condescending “gambatte”s and “no! run!”s from the metropolitan crowd, as well as the occasional question “aruite?” (walking?)
Handing in my chip at the 5K mark to the puzzlement of the staff (I still looked dressed to run), I realized that I had never seen a race from this end; thirty one thousand people… and only a handful are running to win. Some aren’t even trying to race or push themselves. Yet… I have respect for the walkers, the slower runners. Behind the majority, with the cheering crowds reserving their applause for the lead runners, they really are going out alone for their own reasons. Some are just slow, some out of shape, some old, some injured, but they still go through with it.
Such is the draw of the marathon. Before running really took off as a respected competitive event, the 26.2 miles was really seen as a mystical journey, not easily finished, let alone in a decent time. Now, with runners coming in under 2:15 in most races around the world, the distance may not be as daunting, but the name and the history continue to bring in those who would challenge themselves in even attempting to undertake such a task, to become what people like Haile Gebrselassie inspire you to be…
Once a runner, always a runner.
In my lifetime, I’m going to break 2:30.
Winner, Victor Rothlin of Switzerland, in 2:07:23
This year, the Tokyo Marathon doubled as the Olympic Trials for the Japanese Men’s Marathon; probably why we saw so many Japanese contenders come in under 2:10.
Here’s a good one: how many prefectures in Japan have capitals different from the prefectural name? What are they? Don’t google it.bal·ne·ol·o·gy
The science of baths or bathing, especially the study of the therapeutic use of mineral baths.
I personally do not recommend breaking your wrist in Japan. Though, I have to admit, unless you are a millionaire and can afford to stop working and focus on recovery, Japan is the country to have a fracture. Medical care notwithstanding – there are many fine doctors here, including some who have been certified in the US – Japan has quite a unique asset that promotes scar regeneration, fracture healing, and sensory recovery.
The onsen, once again, source of all things pleasurable and beautiful in Japan, is a useful recourse during any kind of recovery. Although there are hot springs tailored to specific ailments (Shimobe Onsen claims to have a significant effect on fractures), any soak in hot water is therapeutic. Add minerals from millions of years of traveling through volcanic veins and water that is several degrees above western standards of comfort, and you’ve got just the right mix of metaphorical morphine and glucosamine
The appearance of scars following surgery can be reduced by massaging the area softly for a few minutes each day, but soaking and moisturizing the area helps.
After your casted limb is once again exposed to the world of hot, cold, wet, dry, pain, and pleasure, you’ll probably find that the nerves don’t exactly work quite the way they used to. Oh, you can feel everything all right, but it’s like a duller, softer sensation. In actuality, the nerves below the skin’s surface feel very inactive. When you do soak them for the first time in the soothing waters of a neighborhood onsen, the change will be immediately obvious: you start to feel stronger and stronger sensations rising from the utmost depths of the body to the surface of the injured limb. But without strong, overwhelming sensations (hot water, excessive movement…), the nerves may never relearn how to feel as you once felt.
Some doctors recommend that your wear a special glove or covering, designed to release a small electric charge through the site of the injury; your body creates this electrical charge naturally through movement of the limb, but if you’re still restricted and want to promote early healing, electricity will help.
From the onsen? The denki furo (電気風呂), or electric bath, is a feature in many onsen that allows you to soak between two oppositely charged plates and reap the rewards of mild stimulation. Between 3-5 minutes is considered beneficial.
INCREDIBLE performance by Victor Rothlin of Switzerland, winning the 2008 Tokyo Marathon in 2:07:23. New course record.
Arudou Debito has coauthored a book with Akira Higuchi to provide comprehensive information for people considering living in Japan. Given the thoroughness of Debito’s website, it’s safe to say this will probably be the most detailed and useful book for New Japanese in terms of legal issues, living, traveling, health care, renting apartments, buying homes, becoming permanent residents, etc. Pick up a copy next month.The only constants in life. I’ll be in Tokyo this weekend limping through the marathon (as I couldn’t get a refund for the registration or flight), but I will return next week with a report on the race, and information on Japanese health insurance and pensions as they pertain to foreign residents.
Join my thoughts as I explore the philosophy of running with John L Parker, author of Once a Runner and the recently released Again to Carthage
8 weeks since the accident
2.5 weeks since wrist surgery
400 years since the publication of Paradise Lost
Honestly, if I could have picked any fracture I would have seen myself getting, it would have been a stress fracture of the leg. Long distance runners, even veterans, have to deal with such inconveniences when training or racing. Stress fractures, unlike sudden impact fractures, build up over time, with small repetitive loads (i.e. running over concrete for miles and miles). Even if your bones are perfectly strong, your muscles may wear out with excessive strain; when the muscles are tired, they tend not to cushion the forces caused by pounding the pavement, and thus the bones receive an unwelcome burden. This is why no runner should ever increase his mileage by more than 10% weekly
In the meantime, however, I’m learning a lot about the medical procedures in Japan, rehabilitation, and proper nutrition – no fractures heal well when the body subjects itself to too much alcohol, caffeine, nicotine, and excess sugar, red meat, salt, etc. In addition, you should try to avoid over-the-counter painkillers like Advil and Tylenol, as these contain anti-inflammatories that makes it particularly difficult for the bones to reattach in the early stages of fracture healing.
Depending on your doctor’s advice, you can begin rehab six weeks after the injury (when the arm has been casted and the cast removed), or 1-2 weeks following surgery (when the splint is removed). Thereupon you can start gentle ROM (range of motion) exercises only: no weight bearing and nothing that causes extreme pain or strain. My wrist joint is still swollen and tight from lack of movement and the invasive surgical procedure, so I wouldn’t dream of doing anything to jeopardize future use of the wrist. When doing exercises, be sure to ice and heat up the wrist in varying stages; some physical therapists suggest alternately dunking the hand in warm and cold water baths, others say to stick with ice. There are even some scar massage techniques orthopedic surgeons suggest you practice 3-4 times daily to prevent the scars from tightening the skin and restricting motion.
If you’re seeking treatment in Japan, be aware that the Momma Orthopedic Clinic listed on the US Embassy website for medical resources in Tokyo is out of business. However, there is another English-speaking orthopedic surgeon in Shinjuku-ku:
Andou Seikeigeka, 安藤整形外科
新宿区新宿3-13-5 クリハシビル 3F
Open Mon-Sat 9 AM – 1 PM; Mon-Fri 2:30-6:30 PM
Finally tonight, I issue a challenge to New York’s own Stephen Colbert, a man who has never by comparison known what wrist pain is. While he was faced with a small chip off the bone due to a slip dancing to Beyoncé music, I had to deal with this:
While he was able to use his wrist with complete range of motion after his cast was removed…
I found this scar staring at me:
Stephen Colbert, I make this challenge to you: a wrist-off. I propose that my left wrist, even lacking the strength endued by marathon running and consistent weight training, is stronger than both of your wrists combined. Let the line be drawn in the sand on the shores of my city of Kagoshima. If you don’t accept my challenge and face me, you’re a coward*.
* I personally have the highest respect for Stephen Colbert and think he’s one of the funniest people on the planet. But, I have to do something with my time when I can’t run.
The Sapporo Snow Festival (札幌雪祭り), arguably one of the best in Japan, ended this Monday. Quickly riding its coattails, the Fairbanks Ice Festival is also held during February. Both of those events bring out some amazing craftsmanship:
It never fails to amaze me just what kind of news stories make it through the international filters of CNN and local US stations; granted, I doubt most American citizens would be interested in a scandal involving food products sold after their expiration dates, but school bullying leading to suicides? The kind of statements politicians get away with over here? More to the point, the behavior of the military of the United States government…?
It wasn’t too long ago I read a story courtesy of Japan Probe illustrating how crimes committed by members of US military were down in Japan
…honestly, I’m amazed people are able to publish a story like that. Military crime is down. So what. It’s not supposed to exist in the first place. If a country can’t rely upon its citizens charged with the greatest responsibility of protecting it (however you may disagree it’s implemented), then quite frankly, no one in that military or the country itself has any moral ground to stand on.
…from 2002 to 2006, there were fewer rapes, robberies, thefts and drug cases involving U.S. servicemembers, family members and civilian workers.
Excellent work, servicemen. Fewer of you have raped, pillaged, and plundered than in the past. You’re right up there with the legions of Rome and the forces of Alexander the Great. So much progress in two thousand years; I can hardly believe it. You alone have managed to prove your civilized behavior by not raping every woman you see, beating the first man who looks at you the wrong way, and stealing everything in sight. Clap. Clap.
In one of the more ironic twists in news history, a Marine stationed in Okinawa was arrested for raping a 14-year-old girl. Less than 24 hours after the decrease in military crime story was released.
[The Marine, Staff Sgt. Tyrone Luther Hadnott] offered to take the girl home on his motorcycle.
The schoolgirl, he said, was walking with her friends and accepted Hadnott’s offer.
This is what happened next, according to police:
Hadnott took the girl to a house, and later to his car. They drove to a park where he allegedly attacked her. On her cell phone, the girl called her friends, who notified police.
Hadnott told authorities he only tried to push the girl down and kiss her. The girl disputed his claims, and police told CNN they intend to file rape charges.
Just as the “amazing” statistics indicate, this is hardly the first time a rape has been reported involving Marines stationed in Japan. As recently as October of last year, a girl accused four Marines stationed at Iwakuni of rape… that incident also happened to fall on the first night of the Sake Matsuri in Higashi-Hiroshima. In 1995, the rape of a 12-year-old girl by three members of the US military in Okinawa prompted authorities to reduce their presence on the island.
The black and white picture of my leg showed no splinters in the bone, but there was a small black pocket where white ligament should have been. Momentarily the doctor arrived, a young, disheveled man with heavy sideburns, tennis shoes, and a slight, worried smile. As he entered the room, the nurses took two steps back, bowed deeply, and asked for his gracious protection. Turning toward me, he began his diagnosis in Japanese. But after realizing I was having difficulty understanding his technical language, he took a deep breath and started again, this time in English.
“Ligament. Rupture. Cast… shall we?”
He breathed an audible sigh of relief and gestured for the nurses to prepare the plaster.
“Excuse me,” I interrupted, moving back into Japanese, “can’t we discuss this a little more?”
Stunned, he sank back into a chair.
What followed was a rather arduous conversation as he repeated the same finding. “Ligament. Rupture. Cast… understand?” I had the uneasy feeling that he knew about six words of English and was adjusting his diagnosis to fit his vocabulary. “You have cancer; we must amputate; have a nice day.” Soon he stopped talking altogether, pulled on his plastic gloves, and declared, “Let’s go.”
Learning to Bow, Bruce Feiler
1. Before you go, you need to pack a bag. Obviously you’ll need clothes, a toothbrush, toothpaste, soap, a few towels, and some snacks. But what you may not realize is you should also bring a fork, chopsticks, indoor slippers, and a cup for tea.
2. Three to four times a day nurses will come by your bed and take your temperature, blood pressure, and measure your pulse. Unlike in the US, Japanese thermometers are used under the armpit.
3. This I cannot stress enough – do not ask for pain medication unless your Japanese is good enough to describe the method of administration. Most hospital meditations are suppositories. You can receive injections, but only if you ask.
4. If you do go into surgery or have some operation, a nurse will come by to collect any money or valuables you might have, to be stored at the nurses station.
5. I can’t even say this… although it also happened to me, I’ll let Mr. Feiler provide the words:
…she reached a final question, which I could not understand.
“Could you repeat that,” I said.
Off she went again. “Something, something, yesterday. Whatsit, whatsit, how many times?” Again, a blank stare from me. Not to be denied, she looked around the room, pulled the curtain closed, and carefully enunciated the word “TO-I-LE-TO,” pointing to her rear end for clarification.
“Ah, I got it,” I announced. “Twice.”
Then the nurse stripped back the covers again and pointed to my crotch. “Weeelll…?”
Now more fully awake and concerned that she had plans to probe me again with her singing thermometer, I answered quickly, “The same.”
In retrospect, the nurse must have been asking me how many times I had made honorable waste.
6. Fight to be discharged. Although the doctor and nurse will usually defer to you, you really have to make the case that you are capable of taking care of yourself once released. Have friends stop by to show you have support. If you still need treatment, ask if you can be a gairai (外来, outpatient).
Here’s a very useful page I wish I’d known about beforehand. It goes over the medical procedures and Japanese social and labor insurance, and the creators provide a medical consultation line in English:
AMDA International Medical Information Center
With my arm being temporarily immobilized and travel, dancing, and adventure sports out of the picture, I’ve had the chance to sit down and put a major dent on a stack of books that I’ve had with me since returning to Kagoshima last Christmas. In addition to those, I found myself purchasing another relatively assuming one while I was passing through the local Kinokuniya last week.
How Starbucks Saved My Life: A Son of Privilege Learns to Live Like Everyone Else. Although one might assume the author had intended to gain a quick buck with a cheap marketing ploy, the story itself is simple, straightforward, and grabbing.
Enter one Michael Gates Gill. Born into wealth (not just riches, wealth) on Manhattan’s Upper East Side. Got a job out of college without even interviewing for a top advertising company, wife and four kids soon followed (gradually sucking the income, I might add). Works there for thirty years
Fired shortly after a merger. Had an affair. Divorced, losing his savings, and now supporting five kids (one from the affair), he still manages to throw down a few dollars and splurge on a Starbucks coffee.
And here’s where we see something remarkable; this man accepts a hourly-wage-paying job at Starbucks. Completely by chance. More to the point, he starts thriving on it, getting more out a job of manual labor and repetitive tasks than he ever did in advertising.
Many of you have heard me criticize tasks like cleaning up in some of my previous posts. The reasons for that aside – not the work itself, just how it’s “sold” to teachers – everyone should experience something like this.
You don’t have to work in a Starbucks on Manhattan Island. You don’t have to be cleaning the restrooms in a steel monstrosity of central Tokyo. But you should know pain. You should know the toils that come with a life of labor, because while you might have the choice to go abroad and teach English, stay at home and work in a cubicle, or achieve your dream job, some don’t; some know only chores that let them survive to the next day.
I’m not trying to adopt a “holier than thou” or “look to the little people” attitude or anything of the sort. Even though I’m currently sitting in a clean apartment having come from a high-paying desk job, you might not realize that, in my lifetime, I have:
– Had my blood plasma collected on a weekly basis so I could have enough money for gas to get to other jobs, necessary for food; a needle was inserted into my left arm, the blood withdrawn, mixed with an anticoagulant, and the red cells returned to me
– Spent full days lifting up trays of heavy dishes, burning my hands from the hot water and my eyes from the bleach fumes
– Had a full-time job that involved cleaning the residue built up in a drainpipe after daily use in a restaurant; to this day I don’t think I’ve smelled anything worse
The point is, don’t ever look down at anyone doing what you consider to be a worthless job. Gill himself was a professional for years and years, and he describes how intimidated he is when asked to work the register at a retail store! The uncertainty he feels in the early days of his Starbucks career: it was in fact a question of if he could do the job. The gratitude that builds for his coworkers and his increasing understanding and humility.
His thinking really does evolve to become more along the lines of Henry David Thoreau, for while he does keep a steady job, an apartment, and ties to the world, he starts seeing life in terms of necessities, not luxuries. And it all derives from his job at Starbucks… I’m aware of the irony.
Think about it: could you work at Starbucks? You might even have smirked or gone over some condescending thoughts one day as you were picking up a triple decaf cappuccino, but do you know how to make that drink? Can you change the oil on your own car, fix the air conditioner, replace the brake liners? Do you think its bad a single mother would choose to work at Dairy Queen to provide some kind of income?
Never assume anything. With regards to Japan, this all ties into the language barrier
…instead of being superficial, we might bother to consider the people behind the language travesty, this illusion we put up in our minds. Where do these travelers come from? They’re obviously here for a reason, and maybe they’re trying to learn the local language. They could be doctors, lawyers, teachers, and office workers, people perfectly capable of being eloquent. But what do we associate with them? Lack of intelligence. “You can’t speak properly, so I must be smarter than you”: an assumption so far from the truth it’s ridiculous.
I encounter a Mexican who can’t speak English in Texas; he could be a professor doing a guest lecture.
An old Japanese woman sees a black man walking the streets of Roppongi late at night: “he must be a sex-crazed dirty gaijin criminal; thank god we’re fingerprinting them now.” The man in question has spent one day in Japan and found himself wandering an area popular with his contacts.
You, fresh in a nicely-pressed suit and tie, come across a unshaven garbage man tossing a load onto the truck… “some of the happiest people in the world come home smelling to high Heaven”
It’s all about personal satisfaction, and that can easily change with age and experience. Not everyone can be a Starbucks barista.. and some people don’t even have that choice.
Live it all: paint fences, clean toliets, scrub floors, dig holes, lift dishes, serve snooty people their drinks, guard buildings, haul trash. You might hate it, but after a time, everyone gets some satisfaction from physical jobs.
Date: Sunday, March 23rd, 2008
Time: 9:00 AM
Location: Minami-tane Town (南種子町) , Tanegashima
DEADLINE: Friday, February 8th
Date: Sunday, March 9th, 2008
Time: 8:00 AM
Location: Kaihin Park, Kaseda, Minami-Satsuma, Kagoshima-ken
Price: ¥3000 (Champion) and ¥2000 (Challenge)
Champion Run 5K, Bike 28K, Run 5K
Challenge Run 2K, Bike 14K, Run 2K
DEADLINE: Friday, February 15th
Download the form here
If you’re living in Japan and not in close proximity to the US Embassy (Tokyo) or Consulates – Fukuoka, Naha, Osaka, Nagoya, Sapporo – this is a useful guide to renewing your US passport. Remember, if you’re planning to travel across the border, some countries won’t let you enter or apply for a visa with a passport set to expire in less than six months.
Also of equal importance – although you might be living in an area with a passport center, it still might be a better idea to renew by mail. Why? The cost, considering all expenses at the time of submission, is approximately the same, as is the processing time. In addition, you won’t have to deal with lines or some snooty bureaucratic official who might be working that day.
Applying for a Passport in Person
Renewing a Passport by Mail
What you need
1. A US passport issued within 15 years when you were sixteen or older; you have to mail this passport with the application.
2. The application form, DS-82, which can be filled out online here
3. Two passport photos. The regulation size for the US is different than Japan’s, naturally, so you need to go down to a Fuji Color or another cheap photo shop and request a specially sized 5×5 cm photo, with a white background. AUTOMATED PHOTO BOOTHS DO NOT OFFER THIS – don’t waste your money. Line it up with the photo on the application to confirm the size, and write your name on the back in felt pen.
4. Two EXPACK500 envelopes. Take the tracking code sticker off each one and keep them accessible. Fill out one with your Japanese address and the other with the closest passport unit:
US Embassy Tokyo
1-10-5 Akasaka, Minato-ku, Tokyo 107-8420
ATTN ACS Unit 11-5 Nishitenma 2-chome, Kita-ku, Osaka 530-8543
2-1-1 Toyama, Urasoe City, Okinawa, Japan 901-2104
5-26 Ohori 2-chome, Chuo-ku, Fukuoka 810-0052
Mail them to Osaka
Kita 1-jo, Nishi 28-chome, Chuo-ku, Sapporo 064-0821
5. The fee has just been changed as of 2/1/2008. $75 dollars for a mail-in application ($100 for in-person requests), which must be paid in US dollars by international postal money order. Go down to a post office offering this service (may need a larger one), and request a 国際郵便為替 (kokusai yuubin kawase) made out to:
US Embassy Tokyo
Unit 45004, Box 205
APO AP 96337-5004
The fee is 2000 yen.
Wrap it up and send it in. The website claims your new passport will be sent to you within 3-4 weeks, but after my first try, I received it in ten days – not bad for bureaucracy.
As of last year, all the new US passport are e-passports, with an electronic chip embedded in the cover that contains the same information that is printed in the passport: name, date of birth, gender, place of birth, dates of passport issuance and expiration, passport number and photo image of the traveler; the e-passport contains security features to prevent the chips from being read, cloned or changed.
This new version certainly contains more history than I remember on my previous ID: the lyrics of The Star-Spangled Banner, the Constitution, quotes from famous Americans, picturesque scenes from around the country, and the smiling eagle. Looks nice.
If you’re a little hesitant about mailing in your only proof of citizenship, I believe local consulates sometimes go out to smaller areas and set up shop for a few days to provide citizen services. I happen to know for a fact that the consulate in Fukuoka will be sending representatives down to Kagoshima in February – call them for specifics, but I’m sure the same could be true of cities like Hiroshima and Aomori.
Don’t forget – once you do receive your new passport, you have to go down to the city office and register the changes on your gaijin card.
In his last published work (after his death in 1993), Alan Booth is once again on the ball in observations of Japanese culture and his very folksy style of writing.
“I trampled out of picturesque Ogimachi unable to make up my mind for certain whether Japan’s signposted fossil culture disappointed and infuriated me or whether I should simply be grateful that the Noh and gasshozukuri villages had not vanished altogether. Was it better for an art to die and be decently buried or to die and be pickled in formaldehyde? The latter was definitely more profitable, I thought; the bin-zasara sold to tourists cost as much as five large dinners.”
This debate has been raging longer than Booth and his travels. Which would you prefer, to fly eight thousand miles away and land in a city not too different from your point of origin? Or would you like it if the locals purposefully revived ancient traditions, superficially for the sake of tourism?
Heroes in Japan
“In the West a hero is presented to a young mind in the hope that he or she will inspire imitation. Japanese heroes, on the other hand, are meant to be admired from as safe and uninvolving a distance as possible. The question of imitating them, if it arose, would likely be laughed at. This is as true of the heroes of popular fiction as it is of historical figures. Take Kuruma Torajiro, or “Tora-san,” the hero of the longest-running film series in the history any nation’s cinema. Tora-san has a heart of gold, a nature so guileless and charitable that one comes away from every episode wishing one’s children, one’s relatives, one’s friends, one’s colleagues at work were blessed with half such a heart. But Tora-san is a bumbler, a dreamer, a loser, a man by circumstance and temperament estranged from his family, lacking education, lacking foresight, lacking material prospects or the remotest chance of achieving a settled life, completely incapable of understanding or occupying a place in what we like to call normal society. This is the source of his comedy and nine-tenths of the reason why audiences love him. But to wish such a plight on our children, relatives, friends, and colleagues – or on ourselves – would be tantamount to idiocy. Yes, we admire Torajiro. But should we strive to be like him? Don’t be ridiculous!
You could take most of the heroes of Japanese popular culture one after the other and show how their creators have sought to ensure that admiration and sympathy do not result in emulation. Often they incorporate into the hero’s life some form of disability or anguish. We might wish we possessed Zatoichi’s skill with a sword but that would hardly compensate for us being blind. We might envy the famous T.V. samurai Kogarashi Monjiro his courage, but to be that friendless, that rootless, that shunned – no thanks. And a similar attitude exists towards many of the real-life figures who attain hero status. Indeed, it often seems as though they are selected for their status precisely because they represent everything that Japanese society teaches its members to avoid. They are not models; they are cautionary examples, and sometimes they are scapegoats. In a conformist nation, they are misfits and sore thumbs; among a materialistic people they pursue impossible dreams.
This is as true of modern heroes like Uemura Naomi – who, in his solitary conquests of some of the world’s highest mountains or his trek across Greenland with no company but huskies, was as unlikely a scion of “group-oriented,” “consensus” society as one could ever hope to meet – as it is of older heroes like Saigo. Lead an armed rebellion for half a year and then flee up and down mountains for sixteen days with swollen testicles? Not likely! Spend the best years of your life in the jungles of America and Africa, surrounded by monkeys and foreigners, dying of fever, scribbling in French, and swallowing the bitter pill of patience? You’ve got to be joking!”
This one I found particularly on the spot, even if the creators of the show “Heroes” happened to disagree by having Hiro Nakamura idolize Kensei Takezo (although, in fairness to Kensei, history simply forgot him being a foreigner and a drunk).
The question remains… how does Link from The Legend of Zelda not merit emulation?
Looking for the Lost, Alan Booth