Treating Foreigners , Part III | The Life of a Hotel Doctor

“Excuse me if I disturb you, Doctor Oppenheim. I have a question. Do you go to Anaheim?” “Anaheim! That’s a long way.” Forty miles. The caller introduced herself as Mariko, a dispatcher from Europ-Assist, an agency that called regularly. “Is it too far?” “It’s far but not too far.” This was my stock answer when I intended to go but wanted to charge extra. I tried not to refuse calls from travel insurance services. Once they found a reliable doctor, the dispatchers grew lazy and called me exclusively. If I refused now and then, they’d send the patient to an emergency room. If I refused too often, they’d stir themselves to find additional doctors, almost certainly among my competitors. With offices on the east coast, their knowledge of California geography was vague, so they often asked me to visit cities so distant I could refuse in good conscience. Anaheim in Orange County was unpleasantly distant, but the cluster of hotels around Disneyland was close enough to make me uneasy. It was better to go, and it helped that agencies agreed to pay double for the long drive. The Japanese department of Europ-Assist used me exclusively. It was separate, apparently down the hall from the main department, which handled Europe and never called. The Japanese dispatchers invariably thanked me effusively for making their visits. Since I also phoned them to interpret, they knew me well and expressed sympathy and puzzlement when asked why the European department never called. They readily agreed to suggest it use me, but this had no effect. Perhaps, being Japanese, they were too polite to refuse but also too polite to bother their colleagues down the hall.

A young Japanese man answered the door and bowed, a custom I found charming before realizing it augured a long, long visit. Sophisticated Japanese know westerners do not bow, so they learn about shaking hands. A bow meant the man spoke no English. With Japanese, no English meant exactly that. Europeans or Latin Americans could usually communicate enough to deal with common problems, but when Japanese bowed, comprehension was zero. For years I was mystified at how badly Japanese spoke English until a friend familiar with the culture enlightened me. He agreed with my observation that Japanese children study English every year until they leave school. “Americans study American history through twelve grades, and how much do they remember…?” he pointed out. “Every student in Japan studies English, so schools hire a huge number of English teachers: 600,000. The teachers have a strong union, so there’s no oversight, so most of them are lousy. Parents will realize if a Japanese teacher can’t teach composition or math or science, but since no one knows English they can get away with it.”

Walking into the room, I observed a woman in bed, looking miserable, a wet cloth over her forehead. Although under the covers, she was fully clothed because in many countries a patient must be in bed when the doctor arrives. I noticed the man thumbing through a Japanese-English phrase book, another sign I needed an interpreter. As I picked up the phone and dialed Europ-Assist, the man looked up and carefully pronounced: “My wife has a dyspeptic condition.” He searched again then added: “Could you please perform a diagnostic evaluation?” Smiling to reassure him, I listened patiently to a recorded announcement in several languages then waited through a minute of muzak before Mariko came on the line. During the insurance agency’s busier times I would hand the phone to a spouse, perform my physical exam, write as much of a note as I could, then sit in dignified but uncomfortable silence until someone answered. It might take five minutes. “Would you ask what’s bothering her and then tell me what she says?” I asked, my habitual opening. Handing over the phone, I sat patiently on the opposite bed as the woman chattered for too long. Homesick as well as ill, patients were grateful for a chance to speak their native language and did so at great length. “What does she say?” I asked after the woman returned the phone. “She feel pain in stomach. Feel like throwing out. Go to bathroom all night. Take Japanese medicine but not help.” Sitting through interpretation took twice as long, and since most Japanese dispatchers spoke rudimentary English, I was certain they left out information. Fortunately, most patients had simple ailments. After thanking Mariko and hanging up, I performed my exam. It was normal although her bowels gurgled loudly when I listened with my stethoscope, a common finding in gastroenteritis. I phoned Mariko again. Through her, I told the patient to sip Seven-up, and assured her she’d feel better by tomorrow. From my bag I extracted a small box of Lomotil for her diarrhea and Thorazine for her nausea. As I left, the husband held out ten dollars, which I waved off. “Please accept gratitude for servicing my wife,” he announced after another glance at his guidebook.