Japan and the United States have very different ideas about pain management,
health care, and how people ought to feel. Both of us having medical issues
means we’ve had a lot of experience with both systems, and we compare the two
from our perspectives.

Transcript

K: So, lately I’ve been thinking a lot about pain management.

C: Yeah?

K: Yeah because I have a new pain guy. And, so, I have an endocrinologist
and a general practitioner that I see. And my GP does my pain management for
me. They’re not, like, officially a pain management guy. 

C: Because pain specialty is really rare here in Japan.

K: Yeah. So, the last time we talked about pain management in Japan versus
the U.S. it was really upsetting for some of our listeners, and so I wanted to
dive a little bit deeper in that. It’s not a subject I’m really comfortable
talking about, though.

C: So, first I want to ask you: why do you have a new pain doctor?

K: Well, because my old doctor has cancer and had cancer for six months
before telling me. And he said, “I’m just going to go in the hospital for a
month for some treatment, so here’s a prescription to get you through”, and
then he retired. And continued to see me for six months after he retired. And,
while he researched another doctor for me because he was also my hereditary
coproporphyria doctor. I thought that was kind of sweet but also kind of
strange. Like, okay, why didn’t you tell me you have cancer? He’s like “if they
won’t see you, I’ll still continue to see you.”

C: Which is nice, but…

K: Yeah, so I had a really great relationship with my previous doctor, so

C: I think that was the fourth or fifth GP you’ve had since we moved to
Japan, and all of them have retired, and that’s why you’ve switched.

K: Yes. This one’s younger than – usually, I like my doctors in their
eighties. (laughs)

C: Yeah, I think the first time that we went to saw – he came to Japan to do
medicine after World War 2, so

K: Yes. Right after World War 2.

C: Right, so I think he’d be over a hundred now.

K: Yeah. I hope he’s still around. I absolutely loved him. He was awesome.
And then my second doctor, I didn’t like him as much because he would spank me.
Like literally spank me on the bottom if my weight went up.

C: Yeah, which is just no. Don’t do that.

K: Yeah, I don’t like that. But, so, I don’t know why I tolerated that. And
then I got sick of that, but he retired, and so I switched to another doctor,
and then he retired. So, now, I’m with a doctor who I think is in his 40s, so

C: Oh, that’s good.

K: Yeah, so I think I can get like – I think he’s the one.

C: I think we might have mentioned this before. So, we’ll talk about pain
management, but one of the reasons that doctors in Japan tend to be older is
because you don’t become rich as a doctor by default.

K: Correct.

C: Because it’s not prohibitively expensive to become a doctor, and medicine
itself is not prohibitively expensive to receive because there’s no insurance
middleman.

K: Right.

C: So, that’s a whole effect of socialized medicine.

K: And we tweet a lot about the fact it costs like five bucks for me to go
see my doctor.

C: Yeah. So, a lot of doctors in the U.S. are horrified of a system like the
Japanese one because you don’t get rich being a doctor in Japan. But it’s
increasingly the case now that you don’t get rich being a doctor in the U.S.
either if you work for Kaiser Permanente or something like that. So, total
digression out of the bat, but pain management.

K: (laughs) Yeah. So, I want to explain something about my pain management
in the United States that I didn’t explain before. And that is the last time I
saw a medical professional in the United States was ten years ago.