Staying healthy in Japan

Features Health - March 25th, 1988

by Elyse M. Rogers


How exciting it is to be able to introduce you to a new, modern. Western-type medical clinic in a convenient spot here in Tokyo! Most every foreigner is acquainted with National Azabu Supermarket in Azabu, so what could be easier than a clinic right in the same building? Also, it’s just a short walk from the Hiroo Station (Hibiya Subway Line).


Let me back up for a min­ute. Years ago I profiled a very charming, dedicated German physician, Heinz Plessner, M.D. Dr. Plessner came to Japan in 1939 and served the foreign community until his re­tirement last year. During the last few years, however, he had reduced his workload (as he had a right to at his considerable age), so not too many new foreigners really knew the doctor. At any rate, we wish him well in his retirement, and welcome Michiko Suwa, M.D., the new owner of the clinic.


The petite young woman doctor, Michiko Suwa, is a Fellow of the American Acade­my of Pediatrics and has a long list of accomplishments. I think you’ll find a short saga of her professional history most interesting:

  • Tokyo Women’s Medical College. Graduated in 1973. She received the Campbell Malsuyama Scholarship award at graduation. This is the award for the top student in the class, which she was for all six years. Pretty impressive!
  • Yokosuka Naval Base. She did her internship at Yo­kosuka (they are qualified to accept Japanese medical stu­dents for internships) for the one-year program.
  • Alberta, Canada. University of Calgary. Here, at the Foothill Hospital (I thought that an unusual name, but she said it is located in “the foothills of   the mountains”). Dr. Suwa spent three years. Two years was in pediatric residency; another year was in medical genetics.
  • Loyola University Medical School, Chicago. She moved to Chicago when she was ac­cepted for a Fellowship in Pediatrics in Neurology, and stayed 18 months.
  • USC at Rancho Los Amigos, California. To the West Coast where she spent a year in a Fellowship for Handi­capped Children at USC. USC at Los Amigos is well known for its medical center for handicapped people.
  • Private practice. Dr. Suwa opened a private pediatric practice in the Los Angeles area and stayed for three years.
  • Japan again. In December, 1986, Dr. Suwa returned to Japan with her husband and two children (boy of 7 and girl of 3).
  • Tokyo Medical Surgical Clinic. Dr. Suwa was working part time at the popular Tokyo clinic until she opened her own National Medical Clinic.


Dr. Suwa will provide gen­eral medical services to patients of all ages in her clinic, but since her specially is pediatrics, (particularly in the area of neurological and genetic dis­orders) I asked the doctor to share with us some of her thoughts or comments on birth defects.

• Cleft  lip and  palate are more common in Asians than in Caucasians.

Spina bifida (a defect in the spinal column where some of the spinal cord may be outside of the body in a sac-like growth at the base of the spine) is more prevalent in Caucasians, particularly those of Scottish or Welsh decent, than in Asians.

• Down’s Syndrome. Am­niocentesis (testing of the amniotic fluid in the mother’s uterus, in which the fetus is immersed) was originally performed on mothers over 35 who had already had one Down’s Syndrome child. But that was before the link was made between Down’s Syn­drome and the older age mo­thers. Today, Dr. Suwa says most physicians suggest all pregnant women having a baby after 35 be tested. If the test is positive the mother can then decide whether or not to abort the fetus.

Many such mothers decide on the abortion alternative, although it’s interesting to note that the Down’s Syndrome As­sociation in the U.S. is against abortion. They say that with infant stimulation (a program of special movements for the child, playing certain types of games with blocks, etc.) the Down’s Syndrome child with an IQ of 40 or so could be brought up to an IQ of 80. Hmmmm. Not to take away from the humanitarian issue, but I think it would be a tough decision to decide to bring a Down’s Syndrome child into the world.

• Hemophilia. Hemophilia (lack of blood-clotting mechanism so that the afflicted can die from a simple cut or tooth extraction because he will bleed to death) is another disease in which abortion can be debated. Amniocentesis can be performed to determine the sex of an infant, so if the mother learns it is a boy (girls do not get the disease) what should she do? There is a 50/ 50 chance that the baby boy will be a hemophiliac. Certain­ly a very, very difficult choice for any expectant parent.

• Hydrocephalus (baby born with a large head, or whose head becomes enlarged be­cause of spinal fluid accumulat­ing in the skull). I was par­ticularly interested in Dr. Suwa’s comments on this con­dition because I had seen many sad cases of this condition in my early clinical practice.

Fortunately new techniques have improved both the quali­ty of life and life expectancy for these children, particularly when early diagnosis (and more complete diagnosis) are possi­ble. New diagnostic aids, such as CT (computerized axial tomography) which takes three dimensional X-rays, and MRI (magnetic resonance imaging) which uses a magnetic field instead of radiation, have been a big help in aiding infants with this condition.


For routine check-ups, Dr. Suwa suggests parents bring the new baby (under one year) to the office three or four times during that year. After that, annual check-ups are the rule. (That sounds great to me, but I never remember having a baby or toddler that could last for a whole year without a visit to the doctor.)

For that important immuni­zation schedule for infants and children, Dr. Suwa explained it’s a bit different in Japan than America, because of the availability of vaccines. For example, because of the way polio vaccine is packaged (in one large container, rather than in individual doses) they only obtain one container every so often and divide up the doses at that time. So, a child may get the routine DPT shot, and not get the polio at that time because it’s not available. DPT stands for diphtheria, tetanus and per­tussis (whooping cough) vac­cine.

Also, the MMR vaccine cannot be given in combination in Japan, so the infant must get separate shots. The initials MMR stand for measles, mumps and rubella (German measles).

The early immunizations for children are usually not a problem because most parents take the young baby for rou­tine check-ups and the im­munization schedule is care­fully monitored by the doctor or clinic. But after those ini­tial shots, boosters are some­times forgotten. As a re­fresher:

  • A DPT booster shot is recommended just before the child enters kindergarten. Again at age 15, it’s recom­mended that the child receive a Td shot (pertussis is not necessary). The capital “T”stands for more tetanus protection, while the small “d” stands for only a bit of diphtheria protection, since that is all that’s needed in the older child.
  • A tetanus booster shot is recommended approximately every 10 years; however, in case of severe injury (such as an automobile accident) the doctor will usually administer another tetanus booster if the patient had the last shot more than five years previously.


I’m delighted to be able to introduce you to Dr. Suwa’s able, Knglish-speaking assistant. Oftentimes we have physicians who speak English, but other professionals in the office don’t, so Ms. Suzuki is a rare find.

Nurse Suzuki was graduated from St. Mary Nursing School in Tokyo, then worked at Glendale Hospital in California for two years. In Japan, she worked at the Bluff Clinic in Yokohama and the Tokyo Medical Surgical Clinic. With her wide experience in clinical nursing, particularly in the fields of pediatrics, obstetrics and gynecology and surgery, she will be of real help to foreigners who go to the Na­tional Medical Clinic.


Fees for service are:

  • Initial consultation usually ¥6,000- ¥12,000, depending on services given.
  • Laboratory fees from ¥2,000.
  • X-rays (in office) from ¥5,000.
  • Inoculations from ¥2,500.

Please note that Japanese National Medical Insurance (kenko hoken) is not accepted, Private health insurance forms will be filled out at a charge of ¥1,000 per form, although an itemized receipt (which con­tains all the information necessary for the patient to fill out his/her own form) is available free of charge.

Payment in cash at time of service is expected, except for those who make arrangements with  the doctor.

Clinic hours are Monday-Friday 9 a.m.-5 p.m. and Sat­urday 9 a.m.-12:30 p.m.

The clinic is located on the fifth floor of the National Azabu Apartments, part of the National Azabu Supermarket building. Walk up the stairs at the side and an elevator is straight ahead.

The office is less than two-minute walk from the Hiroo Subway Station, across from Arisugawa Koen. The 86 bus (from Meguro to Nihonbashi) passes the door and stops nearby. If you need medicines, the National Azabu Supermarket has a licensed pharmacist who speaks English, and a drug section.

Michiko Suwa. M.D., Na­tional Medical Clinic, National Azabu Apartments, 502, 4-5-2 Minami Azabu, Minato-ku, Tokyo 106. Phone 473-2057,