As a result of falling sick here more than a month ago, I am now receiving envelopes with large amounts of paper that have no meaning to me. The insurer has paid the bill.
I had spent a couple days in the hospital as a result of an ulcer that unfortunately hit a small artery. I was in the care of student residents who were earnest and skilled, and who reminded me of my nephew Nick, a resident in Boston.
I am sure the stay was expensive, but I have no idea how much it cost.
I just knew that after I got out I needed to take it easy, no wine, for a month and never again take ibuprofen or any NSAID, non-steroidal anti-inflammatory drug which, I was the last to know, tears up your stomach lining.
A month later I went for a visit to Ishigaki, the verdant island at the very southern end of the Japanese archipelago not far from Taiwan. The occasion was a visit by a shaman who was dealing with some spiritual matters for Sanae’s mother.
After an evening of wandering around the small port town that including a dinner of “stick fries,” which consist of various foods, fish, beef or vegetable, coated in batter and deep-fried, I fell ill again, this time with something much less exotic: the flu.
As my mother used to say, it was a “mean one.”
So I ended up visiting a Japanese clinic. I received excellent care. But I knew the price.
I had simply walked in. The room had maybe 15 people waiting, a number that in the United States, without an appointment, would normally doom you to a few hours waiting.
But after 20 minutes or so, a nurse took my vital signs and drew blood, which was analyzed right there.
The doc who ran the place checked me out, showed me a computer screen with the read-out from the blood analysis and pointed to the numbers that were too high and showed that the flu was indeed a mean one.
Another nurse then put me on a hard, plastic mattress with a hard, tiny head rest, almost a brick, in keeping with the Japanese ascetic style of sleeping. She drew the curtains and painlessly put me on an IV that ran for two hours. At the end, I was given medicine for the flu and for sleep.
The bill, which I paid in cash on the spot, was 5,400 yen, or roughly 54 dollars.
I was a foreigner who simply walked into a well-run clinic in a country with a single-payer model of health care, was quickly and competently helped, and paid a modest fee for care that would cost much more here.
There is no doubt in my mind and apparently most of the nation’s that the Republican-proposed “replacement” of a national system for medical care is a cruel travesty of social support. In the locked-horns fight that has ensued, members of the Democratic minority have little room to acknowledge that the system needs a lot of fixing.
They are fighting radicals, which leaves no room for compromise.
In the shadow of that great conflict, I have noticed the rise of a new phenomenon in the United States: emergency clinics popping up where you can stop in and get quick help for a modest fee. Not at all unlike the Japanese system.
The one close to my place is staffed by one assistant and one doctor, and from what I could tell nobody else. The local clinics of course cannot treat a life-threatening gastrointestinal bleed. But they could treat the flu.
So somehow out of the wreckage of Big Medicine in our nation, an alternative is emerging that covers some of the terrain between no care at all and serious medical help, one aspect of the re-inventing genius of America.
But I did not want to leave the trip to Ishigaki without a description of the doctor of the spirits, the shaman. A woman in her late 30s I would guess, dressed in everyday clothes, with a husband and two children, she is said to have the gift of second sight.
She is much sought after and charges a hefty fee for her intervention, a whole lot more than the medical doctor.
I was accompanying Sanae, her mother, her sister and the shaman. I watched as they entered a small patch of grass surrounded by a stone wall. On the edges were green trees, bushes and vines. The women were wearing white and black and the sun and shade mixed in the glade. I could just see patches of the women’s white shirts and dark hats through the green leaves, as the shaman performed a ritual.
This spot among the sugar cane fields was where Sanae’s grandmother, who was also believed to have second sight, would come to pray to the spirits before the village’s yearly festival in late summer. She was the medium between the village and the gods.
The shaman saw me watching from the tiny van (after I had a phone conference with our lawyers over court access) and invited me into the glade. She instructed me to stop at the entrance, a break in the stone wall, and pray.
Then, on other side of the glade, I was instructed to toss three yen, only three, on the ground in front of a stone with an old urn sitting on it. And then kneel and pray to the dragon which, the shaman said, was sitting there.
She asked me if I could see it.
What I felt was that it was a special and peaceful spot, and I was honored to have been invited in.