I was sick for the majority of last semester. I resisted going to the doctor for the first month or so of my cold; it wasn’t until I felt too sick to go to class that I finally gave in to get a doctor’s note for an excused absence. Now, I know it sounds childish to not want to go to the doctor, in fact, my host family asked me several times why I wouldn’t just go. My host sister, in particular, was very confused by my behavior. I used it as an opportunity to explain the difference in American and Japanese health care to them, making the excuse that my resistance was just culturally ingrained in my being due to higher healthcare costs. Well, that and dealing with colds by buying Dayquil and continuing with my life. I think that Dayquil may be illegal here, and many of my close friends and family have probably heard me say that it is, but in fact-checking myself for this post I couldn’t find a clear answer. Definitely, some over the counter and prescription medicines legal in the United States are not in Japan, and those traveling have to be careful what they bring. According to the US Embassy in Japan’s website “Stimulant drugs including methamphetamines and amphetamines, some prescription medications such as Adderall; Pseudoephedrine, [and] Codeine” are all illegal.

But I digress.

The truth behind my refusal to go to the doctor was as childish as my actions: I was scared. This fear stemmed from my constant companion, the language barrier. In Japanese, the word for hospital is byouin (spelled 病院 in kanji or びょういん in hiragana). Whenever my host mother, Megumi asked if I wanted to go to the doctor she asked if I wanted to go to the byuoin, and I couldn’t fathom what kind of set up or process would be involved with going to a hospital for just a cold. Because I have anxiety and new situations scare me – which might be a shock to any reader of a study abroad blog – I did not want to find out. Finally, though, I didn’t have much of a choice, and I was so sick that I didn’t really care anymore. And that’s when the truth was revealed. The Japanese concept of a hospital is not the same as mine.

When I told Megumi I wanted to go, she took my national health insurance card to reserve an appointment time. I think walk-ins are also welcome but both times I’ve gone she’s done this. When we arrived I expected a large hospital like the one near Nanzan University. Nope, not even close. We pull up to a small building that says “clinic” or actually “クリニック” which is pronounced “kurinikku” or, you know, clinic (good ol’ katakana words). I don’t know why in spoken language clinics are called hospitals, and I tried to ask Megumi and she just didn’t understand the question. I guess, just as many Americans can’t distinguish between a yam and a sweet potato, the concept of a hospital and a clinic are one and the same.

When we walked in there was a big room, the reception desk was in front, and the waiting area was to the left. Megumi let them know we were there and we sat down. In front of all the chairs was some shelving with various health pamphlets and magazines. Typical doctor’s office stuff. When my name was called I assumed that I was about to be brought into a room. Thankfully Megumi was there to direct me because I was actually being called to walk around to the other side of the shelf and sit in those chairs. After another five or so minutes I was taken to see the doctor. The appointment was pretty quick, he asked me a couple questions about my symptoms, listened to my heart, asked me some more questions that felt random (I later realized they were to determine what medicine to prescribe), and then we left. I paid for the appointment then went next door to the pharmacy for the medicine he prescribed, and went home.

I was so excited to take the medicine because I felt awful. Before I did though, I tried to look them up and figure out what was given to me, but I couldn’t find anything. So like all my fellow CJS students who told me about their adventures with being sick, I just shrugged and took the stuff. And when I did, boy did I feel good, like really good. The kind of good that you laugh to yourself and think “what in the world did I just take?” So the search began again, and after a while, I found one of the most useful sites for living in Japan, kusuri no shiori or drug information sheet (link). On this website, I was able to find all but one of the drugs with English information, including ingredients, usages, side effects, and pill images/descriptions. The other one was available in Japanese only, so then I used google translate to get the gist of what it was. And what it was was an opioid, which explained a lot.

I took the meds (although I stopped the opioid after the worst of the cold past because I still needed my brain for school), and got completely better except for my cough, which persisted. A month or so later I had a really bad cold, again. And just in time for finals! But this time when we went to the “hospital” the doctor wanted to run some more tests in case I had pneumonia (spoiler: I didn’t and am a-okay). First I took a breath test which was really complicated to figure out how to do. The poor technician and Megumi spent about five minutes making sure I understood how it worked. I had to exhale, put this tube in my mouth, inhale, then exhale again into the tube. And then, the really hard part, there was a tri-color scale. I can’t remember the exact colors but let’s say they went from red to green to blue. The important thing was to exhale with enough force to get a line into the green and keep it there. It was so difficult, and what made it harder was that the tech and Megumi were very loudly cheering me on. They said things like “you can do it” and “yes, green, green green green!” which just made me want to laugh. But when I failed, they just cheered harder the next time. Even with their strange cheering, I did it, and I can officially confirm I don’t have asthma. Next, I was taken in for a chest x-ray. Which was so much simpler than when I had to get one to come to Japan – a requirement by Nanzan to make sure no one had TB. I say that because when I had it done in the states I had to change into a hospital gown and stand in very uncomfortable ways. Here they didn’t make me change, and had me stand in strange, but not uncomfortable ways. As I already said, my new cold wasn’t serious; the doctor gave me different meds and I am now cough and cold free.

So how much did two doctors visits, some testing, and ~6 different medicines cost me? For starters, I have national health insurance, it’s legally required that anyone on a long-term visa enroll. The cost varies depending on the place of residence, and as a student, I receive a reduced rate. I was hoping to make an educational post about signing up for this, but I wouldn’t really know what to write. I went to the ward office with Megumi and she did all the talking. I signed where I was told and that was that. The cost for me was 5700 yen the first month and 1000 yen a month after that. Which averages to about 1633 yen a month for my whole stay, or 16.33 USD. The first doctor visit was ~1000 yen, and the medicine was 1100 yen, so ~2100 yen or US $21 for a doctor’s visit and medicine. The second visit with the additional tests was 2000 yen and the medicine was 1310 yen, totaling 3310 yen or about $33.10. I don’t want to make a big political statement about healthcare systems and costs, but I do have to say it was a little frustrating having to pay $21 when I just a had a cold, where in the US I can pick up DayQuil for about 8 dollars. However, the second time when there was a concern it could be more than just a cold, it was nice paying only ~$30 to make sure I wasn’t going to die in a foreign country.

On the subject of healthcare cost, over the counter medicine is really expensive here. I take ibuprofen semi-frequently because I get a lot of headaches. I wasn’t concerned because I was told by my professors and the internet that ibuprofen can be bought here, no worries. What they failed to mention is that ibuprofen costs about 20 dollars for only 36 gel capsules, or only 12 doses if you take 600 mg (the recommended dosage is 400mg, consult your doctor before taking more). For comparison, $20 gets you 200 brand name, gel capsules in America. So if that’s something you take, consider bringing the legal import limit with you. I plan to write another post about bringing medicine into Japan because I did that. And I could have used some help from the internet.