GODA
NEUROLOGY
CLINIC

Originally posted as 沖縄、僕の自慢の（？）研修医時代 in 南区医師会報　

My Internship, Okinawa in The Bulletin of Minami Ward Medical Society

I wrote this essay about 20 years ago when I first opened my practice. SG

I arrived in Okinawa a few hours after having said farewell to my parents as if I were going abroad on the last day in March (when it was still not very hot in Fukuoka). As I stepped out of the airplane onto the boarding ramp, the sunshine was not strong, but the muggy, hot air after the rain suddenly rushed in and made me realize that my impression of going abroad wasn’t exactly wrong.

I got off the ramp and started to stroll trepidatiously across the wet runway, and the two years of my long and painful life in Okinawa were about to begin. Dragging a suitcase full of textbooks and manuals for each discipline of clinical medicine, which I had packed as a guard against my insecurity, and a few clothes; in fact, in my two years of living in Okinawa, I would only need a white coat and scrubs for most of the time, so I didn’t need any clothes other than underwear.

I took buses and reached the Chubu Hospital on the evening of the same day. The resident’s quarters were located behind the hospital cafeteria, and some rooms didn’t have windows, but in my case, we had a room with a window (although there was an ugly concrete wall in front of the window). There was no mobile phone, not even a beeper then. When my roommate was on call, I couldn’t get any sleep because of the frequent calls to the room from the wards, even if I wasn’t on call. I was wearing a white lab coat over my scrubs, stuffed with notebooks and manuals in my pockets, lying on my back with a stethoscope around my neck (it was hard to turn over in that position), and just as I was falling asleep, I would often receive calls from the ward saying something like someone was not breathing, so I would jump out of the bed, step out of the room, dash up the stairs and be in the ward immediately.

The advantage of the extreme proximity of work and home was that I could sleep in my own room even on my shift, but the disadvantage was that I could not leave the hospital even if I was not on call. Summer in Okinawa was supposed to be hot, but I often caught a cold because I couldn’t get out of the hospital where it was too cold because of the air conditioning. When I went outside to go to the bank, which was an infrequent necessity, I felt so dizzy from the glare of the outside world that my eyes went nearly blind.

There was an orientation, but it wasn’t memorable in anyway, and the rotation of the OB/GYN started. Of course being a newbie there was nothing you can do but watch. I was on call with the staff and the resident, and I had to follow the resident around all day long like puppies. When we had deliveries, I would behave as if I were an actual doctor, following the guidance of the midwife, or rather, doing what she told me to do. My first suture was one after an episiotomy. The staff doctor had demonstrated to me many times, but I couldn’t get it even despite crying out of frustration. The doctor seemed somewhat embarrassed and ended up repeating himself using wiping clothes.

Eventually I got it, and when there were several deliveries a night and we were using delivery beds at the same time, I was able to do most of the work alone with the midwife. Being solitary at least in mind after the climax of the childbirth, though the mother was still there utterly absent-minded, in a room with almost no sound, smelling the blood and stitching up the episiotomies again and again into the dawn, numb in consciousness, was somehow very surreal.

This could be called a rite of passage so to speak. I would have to be drunk to call myself a great doctor, but I often feel that what I experienced in the first two years, for better or worse shaped me somehow. When I think about my life back then, it seems natural that I couldn’t have done things such as basic medical research at the university.

Doctor’s job should be dramatic and interesting in a way, even though things don’t work the way they are supposed to and I’m sure I was used to it not working out the way it should, but it’s hard to get used to the absurd world of insurance billing. It’s like talking to a Chinese person in Japanese who doesn’t understand Japanese at all, and I’m not at all inclined to ask for a request for review when the claims were rejected. Would I be a greater practitioner if I had found the rules of health insurance system less ridiculous and more interesting? I am becoming a grouch.

I believe that 20 years from now, I will be reminded of the good old days when I first opened my practice.

2020/04/28