Samurai Orthopedic Surgeon

Samurai Orthopedic Surgeon

As a train-commuting foreign salaryman in Tokyo, you’re always just a leg injury away from descending into something that belongs in Dante’s Circles of Hell: the experience of being a foreign lame duck here. The minute you roll an ankle, or blow out a knee playing basketball as I did, the wonderful cafes, chair massages and bars that buffer the already stifling urban grind fade from your menu.

Walking on crutches, you don’t dare stray from the straight-line course that gets you to work and back in one piece each day. It’s takes all you’ve got to handle the wicked obstacle course that Tokyo becomes without two good wheels under you.

My Tokyo morning train

      My morning Tokyo train

First off, using crutches to walk around Tokyo all day quickly turns your hands numb and arms achy. So instead of cocktails and fun, you spend your nights mapping out new train routes to the office that slice minutes off your walking time (Tokyo is brilliant that way – there’s always several sneaky options for getting to the same place). And on the trains each day, you pray that one of the exhausted salarymen sleeping in the handicap seats wakes up, notices you and gives up his seat.

Sometimes this happens, but when it doesn’t, you have to stand and balance yourself on one leg, like a flamingo, and sway on your crutches for the 60 minutes it takes to get to your station. If you do snag a seat, your hurt leg sticks out straight into the aisle and parts the mass of commuting humanity.

You’re head is on a swivel as you identify various threats to your knee: the older salaryman in front of you on your left who is so exhausted that he snores while standing, the 80-pound middle-aged office lady who’s been smooshed by the crowd and dangles dangerously over your legs, the young schoolboy straddling your feet carelessly with his head buried in a video game player.

You have to pop up using your one good leg and stand in your seat to get your protruding limb out of their way at every stop so they don’t fall over it. This routine happens 20 times as you take the local train to your destination: sit 5 minutes-pop up 1 minute, sit 5 minutes-pop up 1 minute, etc.

When you finally get to your connecting station, you then discover that you badly miscalculated in your planning the night before, as the following awaits you:


Still, I had some degree of control over these post-operation, daily commuting disasters. And I found an excellent way to deal with my train hell: I invented a discrete, in-train cocktail that mixes convenience-store bought 40-proof shochu with a can of lemon-flavored Chu-HI liquor.  The plain water bottle you pour it into ensures nobody knows that your hip-flasking your way home (this also is further proof of my theory that Tokyo has a perfect consumer antidote for each and every one of a commuter’s stresses):

  My Tokyo Hip Flask Cocktail

The trains were one thing, but my built-in language handicap actually presented far more danger during my pre-surgery doctor visits and during my hospital stay.

At my first visit with my knee surgeon, he pronounced, in rapid-fire Japanese without blinking, that my knee’s meniscus was torn but could be stitched up and repaired. This much I thought I followed, and it was a great relief.

I wanted no part of having a big chunk of it removed – a.k.a “meniscectomy” – and the increased risk of having to walk around like Fred Sanford later in life.

As I tend to do when high-level Japanese conversations flow out of my range, my mind began to wander as he kept talking. I started to notice there was a robotic precision to his movements as he talked, his head moving up-and-down and side-to-side in unison with his svelte hands.

To a clumsy and fat-fingered American guy like me, it suggested the famous manual dexterity of the Japanese. I counted myself lucky to have hurt myself in a land of such naturally coordinated surgeons.

But my ease of mind was knocked to ruins when I opened up my surgery instruction guide a few days later. The name of my procedure was written in Japanese on the top in big block letters: MENISCECTOMY. When I had spaced out, did he do a 180, as in, “I’d like to repair it…but then of course, etc. etc.”? Or was he just being non-committal until he opened me up?

Or worse yet, as I dreamed later that night, did I make some dumb Japanese paperwork error at the hospital and sign up for a meniscus chop job?

I saw that the Japanese kanji used to spell meniscectomy – 半月切除 – contained a symbol that literally means “cut out”….


……and since the right radical of the character literally means “sword”, and is meant to resemble a blade, it has several violent meanings.

Seeing this brutal character associated with my knee surgery chilled my spine. As I slept that night, my imagination ran wild. In my nightmare, my paperwork error was irreversible, and a Samurai Orthopedic Surgeon took aim at my meniscus on the operating table:


Of course, it was all just a nurse’s clerical error, and it was quickly cleared up. My focus soon became not on the surgery itself, but on the comforts of my 7 DAY HOSPITAL STAY after surgery. This is a perk of Japanese universal health care, but the stay was sprinkled with danger thanks to my foreignness.

Past knee surgery experience in the U.S. had taught me to avoid the post-op bladder catheter if at all possible. Land of blessed manual dexterity be damned, the horrible 60 seconds of nurse catheter tube insertion was not something I ever wanted to experience again.

I asked the head nurse, and she not only first refused me on the grounds of hospital rules, but told me I’d have to keep a catheter in for a WHOLE NIGHT AND DAY after surgery to prevent messes (the rules, I learned, were designed for their typical patient: a disabled 70-something-year old Japanese man).

She lectured me that since I was sharing a recovery room with 6 other elderly patients, all following this rule, I MUST obey the rule like them.

But my Samurai Surgeon was on my side when I escalated the discussion to him, and she settled the catheter debate by giving me a little, bedside pitcher-like thing to relieve myself in when I needed (while also giving me my first free market victory vs. Japanese socialized medicine, or as I call it, Mitamacare.. But I still bore a social cost: the whole room no doubt could hear every drop coming from me whenever I went as our beds were only separated by a thin curtain, and a couple of times I had a pop-in nurse visit in the middle of taking care of my business).

So I won on this one, but only because I’d carefully prepared myself for the catheter debate by researching in advance all the Japanese vocabulary I’d need to win.

From there on out, I was skating in no-foreign-man’s land.

Before surgery, I hadn’t realized that I set off alarms with my anesthesiologist about my asthma. His eyes widened when I showed him my American inhaler, and this apparently trumped my explanation about how mild my asthma was. The alien prescription totally spooked him.

So he directed my nurses to cut me off from all the good pain medication stuff in an apparent ultra-conservative attempt to prevent some imagined asthma attack induced by….my comfort at being relieved from great pain, I guess. His attention to safety I suppose was laudable, and otherwise the service of the Japanese nurses was really beyond all praise, but I brusquely forgot all manners the morning after my surgery.

When I found out why normal pain meds hadn’t been given to me all night, I yelled, “Forget the asthma, will you?! This damn thing is killing me!”. That did the trick.

A couple of days later, when I developed a high fever from an infection in my arm from the IV tube, a nurse explained that she had to quickly deliver a fever-reducer to me in a non-IV way. She told me to roll over, and from what I grasped, she’d inject something “on” my butt.

As I bared by bottom, her hands probed much deeper than I expected and I exclaimed, “Oh! You mean IN, not ON!”. Within a millisecond the Eagle had landed, and I had myself a Chevy Chase-meets-proctologist moment from Fletch:


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