These past few weeks have reminded me of an old Catholic joke.

St. Peter’s at the Pearly Gates, and he’s checking his list of the recently departed when a new soul suddenly arrives without warning. St. Peter glances down at the list, doesn’t see any new names, then glares at the newcomer.

“How’d you get here so quickly?” he demands.

“Flu.”

Not that anybody in my family has been that sick lately, but we did experience a little merry-go-round of early spring colds the last couple weeks of February. Fortunately none of us got the flu, though, maybe because of the flu shots we all got.

Inside a local hospital, waiting after my "new type" flu shot.

In January and February, we had scheduled our daughter for the last batch of her immunizations (yobou sesshu 予防接種, or also wakuchin ワクチン  from the German word for “vaccine.”). The most important is called “san-kon” (三混), which literally means “three mixed” and includes diptheria, pertussis (“whooping cough”), and tetanus. We also wanted her to get an influenza shot, particularly since there were fears that H1N1 (called “shingata” or “new type” in Japanese) would start up again among elementary school age children. I got the shot last year, and this year I got it again as a combination of seasonal flu and “new type” flu. My wife also got it, for the first time.

Being under the age of 12, our daughter had to get the flu shot twice, about three to four weeks apart. Each shot also had to be at least a week before or after any other kind of shot, and she was not allowed to have a fever of over 37.5 C for several days prior to the shot. Since a slight fever is a typical side-effect of a regular immunization shot, the timing was a little complicated. Each time she got the shot, we additionally had to wait for half an hour in the hospital to make sure there were no severe side effects (such as a temporary seizure or muscle spasms, which did happen to the child of a friend of mine).

Each time we went to the hospital, I had to fill out a questionnaire with the same family history questions. The first time I had some difficulty with the Chinese characters in the questionnaire and asked the nurse attendant whether they were necessary or not. She huffily snatched the clipboard from me (had no one asked such a thing before?) and brought it to the doctor, so when I took my daughter in to see him, he asked the questions and rephrased them so I could understand them more easily. The content was fairly straightforward; Does anybody in your family have a history of allergic reactions to immunizations? Has the patient ever had a reaction? When is the last time the patient had an immunization? Etc. I had to do the same questions again and again each time she got a shot.

I found the questions about family history and my daughter’s immunizations a bit odd. Not only did I have to hand in the “boshi-techo,” which had a written record of my daughter’s immunization, but the doctor was the same person who had treated my daughter for dehydration last April. Wasn’t all this recorded on computer already?

The answer, naturally, is that first of all medical facilities in Japan do not share patient records. Evidently they think sharing patient histories constitutes some sort of violation of privacy…even if the patients say it’s okay to share. Second, the medical insurance and family history records are automatically deleted from the computer system at the beginning of each month, so that all insurance information and family history records have to be manually input each time there is a visit to the doctor.

The cash register counter, complete with notices (many of them handwritten in pen or marker).

I suppose I should have guessed as much. Every hospital I have ever visited in Japan has walls literally covered in handscrawled notices and warnings about washing hands, gargling, dietary restrictions, insurance updates, various illnesses running rampant, taking the proper dosage of medicine, not forgetting to take your umbrella/hat/bag/wallet/spouse home with you once the visit to the doctor is concluded…

For an advanced country with the longest lifespan of any population on earth, Japan sure seems fairly unadvanced as far as medical practice is concerned. Well, maybe not the practice of medicine so much as the system by which medicine is practiced. Inefficiency is not particularly helpful in a society in which almost 30% are over the age of 65.

And did I mention that the pediatrics department at the local private hospital will cease to exist in two weeks? The only pediatrician is retiring. Perfect timing…