by Elyse M. Rogers
ARE YOU A NOSOPHOBIC?
Last month, in the CWAJ (College Women’s Association of Japan) Lecture Series, Japan and Europe Dialogues, I moderated a panel that was called “Medicine and Health: Attitudes and Practices.” I will be bringing you excerpts from that discussion in future columns because the three physicians on the panel had many interesting things to say.
During my brief talk at that time I discussed the fact that cultures have different medical and health practices, and that if those practices work well for that particular culture, then that is what is important. In other words, medical systems can be different without being right or wrong. And often we can learn from these differences.
For example, I feel the Japanese could work on their emergency medical system. Currently it is swift and efficient, but is actually little more than a transport system. Adopting the Western nations’ practice of staffing ambulances with top-notch emergency Medical Technicians and furnishing them with state-of-the-art medical equipment would be welcomed by Japanese as well as foreign residents.
On the other hand, I think we Westerners could profit from adopting some things from the Japanese, as well. For one thing, we might accept a bit of their more fatalistic approach to death and illness. They seem much less panicked about health than most of us Westerners.
And that brings me to what recently became a new word in my vocabulary—nosophobia. Nosophobia is defined as a morbid dread of illness, and it appears to have gripped many Westerners today, particularly Americans. Certainly no one wants illness, particularly serious illness to be visited on himself or his family. And no one wants untimely death for himself or his family either. What most of us would like, if we had our druthers, would be to live healthy lives until a ripe old age, and then die quietly and peacefully at night with no pain or suffering. That’s the dream; reality is somewhat different.
Docs this mean we should not be concerned about our own health practices, or that we should not strive to get the best possible medical care for ourselves and our families if and when we do get sick? Of course not. But it does mean that we should keep things in perspective, and that includes health, disease and even death.
Whenever we talk about illness, injury or death, we are also talking about risk. And risk is not a new word or idea. The concept has been with us for centuries.
Every one of us takes all kinds of risks. We “risk” our money on a raffle ticket that gives us the opportunity to win a car for just a dollar; we take big risks like consenting to major surgery because if the surgery is successful we will be cured of a hernia or cancer.
But those are “voluntary risks” or risks that we consent to of our own free will. We’re not so happy about “involuntary” risks that arc imposed on us from outside. In the medical and health area, many of us do not mind risking our health to continue personal harmful habits such as smoking cigarettes or overeating, but resent any exposure to even minimal risks such as food additives that arc more helpful than harmful, or to the chlorine that keeps our water system’s germ free for millions, but which adversely affects a few.
This worry about risk has led more and more of us to demand a “zero risk” situation. Could saccharin possibly be harmful if taken in mammoth quantities? Outlaw it! Might an AIDS carrier enter our country? Throw him out (despite the fact that he may have gotten his AIDS exposure through no self fault).
We seem to think that life today is riskier than ever. But that’s not true. Modern-day risks have replaced risks of yesteryear. We worry about what pesticides themselves might do to our health; we conveniently forget that pesticides control insects that gave us serious, often fatal illnesses or whose penetrations into substances led to subsequent microbial and fungal contamination.
We must somehow keep it all in perspective. I like one of Bob Hope’s quips: “America is the only country where we want to ban saccharin and legalize marijuana.” And I’d like to add, “where handguns are legal but jaywalking is not.”
BAD NEWS IS NEWS
Adding to our anxiety is the average newspaper which is long on bad news and short on good news. But we readers seem to enjoy it. Newsweek columnist George Will once wrote, “Only man is perverse enough to feel most alive when the news is most lurid… if some great catastrophe is not announced every morning, we feel a certain void. ‘Nothing in the paper today,’ we sigh.”
With this pessimism gripping many of us, we think nostalgically of times past. We want to the “Good Old Days” that seem so “warm and fuzzy.” In reality they were not very pleasant. At the turn of the century in the U.S., the average life-expectancy was 46 (35 is you were non-white). Typhoid, tuberculosis, diphtheria, intestinal infectious diseases, pneumonia, stomach cancer and whooping cough all were common. And often were fatal.
If you had ulcers, needed surgery, had hypertension or diabetes, you were in deep trouble. Problems during childbirth often proved fatal. Care to wander back even further, to the 1850s? It’s worse. Modern sanitation was unknown; wells were dug too close to privvies or animal pens so that most well water was contaminated. Milk was not refrigerated or pasteurized and often was laced with chalk or plaster of Paris to make it look “creamier.”
Doctors did make house calls but they had little to offer the sick patient as they were pretty ignorant of anatomy and physiology and relied heavily on powerful pain killers like morphine and opium which often comprised about 70% of the medications they carried in those imposing black bags. Patients were bled, purged and dosed with ineffectual or dangerous medicines, many dying from the cures or becoming hopeless drug addicts for life. And, although the 50-cent fee for the doctor’s visit might sound wonderful, remember that the average worker made about $3-5 per week.
TODAY IN TOKYO
You might be thinking at this point that information on the medical problems of the last century may be all good, but it has little bearing on what we are doing or thinking in Tokyo today.
So, let’s get current. Let’s talk about the major medical/health question that I hear every day from readers, friends and business associates:
“How can I be sure I will get prompt and competent help in a medical emergency?”
This remains the most-asked question, although I’m pleased to report that it is asked less frequently than it was when I arrived six-and-a-half years ago, and with much less anxiety. I’d like to think that the change for better is in some small measure due to my participation, but also must give credit to the general increasing internationalization of Tokyo and Japan.
Today, at the 119 emergency number in Tokyo (not in other areas of the country as yet) there arc staff available who speak English. And if an English-speaking foreigner calls the ambulance, every effort is made to take him/her to a hospital where that language is spoken. The system isn’t perfect, but then few things are in life.
And perfection is rather the point here—or lack of it. There is probably no place on the entire globe where one can have a guarantee that the absolutely most perfect emergency equipment and trained personnel will be available at the precise moment it’s needed. Or that it will arrive instantly on the doorstep. For that’s just not the way life works. Even excellent equipment break down; wonderfully trained employees get sick; and traffic jams or accidents block prompt transport. In other words, we do not and never will have a risk-free environment.
So, what do we do? We learn the emergency system in use and make the best preparations for it in case we need it. That’s wise and prudent. Then, we get on with living and stop worrying about it. Unfortunately, I know of many who do nothing to prepare but spend a lot of time worrying themselves sick about the “what if?” type of situations. We’ve recently learned that a happy, positive outlook on life makes us healthier, so it stands to reason that nosophobia could actually contribute to our ill health.
So, let’s keep in mind that we are the healthiest, longest-lived people in the history of our planet, follow a prudent life-style (don’t smoke, drink moderately, exercise regularly and watch the red-meat consumption) and stop fretting about what “might” happen. And let’s not forget that ultimately man is a mortal being.
I’ve had the pleasure of meeting many of you out there and I must say that you are one of the nicest looking, genkiest bunch I’ve ever seen! So smile, enjoy life, and don’t succumb to nosophobia!