かえります – I'm Going Home

I only have two more days left in Nagasaki. On Friday I will leave, probably forever. I am very happy that I have done this, and that my work here is nearly over – because it was hard – but it won't be easy leaving my friends and some of the quirky things about Japan that I have come to take for granted. I'm a little overwhelmed at the moment. I have thought about the journey home a lot in the past six months and now it is two days away – wow. This has felt like a time-out from my life so it might be difficult getting back into the swing of things in England. Still, I don't think English food will taste as good, English weather will feel as refreshing, or the English language will sound as melodic as it will next Monday.

My journey home should work out something like this: I am leaving Nagasaki on Friday morning, getting a bus to Fukuoka airport, then hopping on a plane for Tokyo. I will spend the next three nights in the Tokyo International Youth Hostel in Shinjuku-ku and spend the following two days sightseeing in and around the city. Then first thing on Monday morning, I will go to Narita International Airport and get a 12noon flight to London Heathrow. My Dad is meeting me at the airport and he will drive me back home to Preston. *sighs* It will be a very interesting next few days, I think. May is travelling with me as far as Fukuoka airport. From there she is flying to Korea to spend the next three weeks with some of her relatives there. After that she is coming back to Japan and spending a week in Tokyo, then flying back home to Vancouver. I am going to miss her a lot.

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Random photograph: Below is a photo of my favourite road sign. Many of you may not have a favourite road sign but I do. According to this sign, there are only two things you need to worry about: Nagasaki, which is two kilometres underground, and Hirado, which is one hundred and nine kilometres up in the sky. The Most Informative Sign in the World is situated about 2km from Nagasaki train station, which I suppose is the centre if the city. But really, if you hadn't figured out which city you were in until you were that close to the centre, then a sign that says you either need to start digging or head upward to Hirado (apparently your only other option) is surely just going to cause more confusion.

Placement Summary

I was asked by Kimura-san to write an article for the hospital newspaper, summarizing my placement in Nagasaki. Here is it, spelling and grammatical errors included:

Something To Tell The Grandchildren

I was told by many people before I came here that the six months I was due to spend in Japan would fly by at an alarming speed. At first I didn't believe them but now, looking back, they were absolutely right. It was a shock to the system initially, being thrown into the middle of a Japanese hospital, but so many of the staff tried to welcome May and I as warmly as they could that we soon started to feel not like temporary volunteers, but as members of the hospital. It was this fact that made my placement so enjoyable and it is this fact that makes me sad to be leaving Nagasaki.

Since coming to Japan I have encountered many things for the first time. It has been a long series of firsts after another, in fact. This was the first time I have lived alone and in a foreign country, the first time I have had a full-time job, and the first time I have put my life in the hands of a fugu chef (the latter causing much trepidation among my family). Being constantly confronted by things that were unfamiliar to me was very difficult at times, but equally, very rewarding. It has encouraged me to be less inhibited, more open-minded and more fearless.

There have been many wonderful and exciting events in the past half a year that I will always remember fondly. Some of the highlights for me are as follows:

● Seeing Nagasaki's O Kunchi Matsuri – it was definitely worth waking up early for!
● Travelling to Kumamoto for the Kyushu Red Cross Sports Competition – I was proud to cheer for my hospital, especially after seeing many of the staff consume an impressive amount of alcohol during the bus journey and opening ceremony.
● Watching a surgical procedure for the first time – and the second, and the third... Thank you to all of the surgeons and surgical nurses who allowed me to peer over their shoulders on the numerous occasions I managed to make my way into the surgery room.
● Bonenkai – Need I say more?

Of course, it wasn't all road trips and parties, May and I worked a little bit too. We worked in the nurses stations, the pharmacy, radiology, test department, operation room, kitchen, medical matters and nursery. Having a schedule that had me working in a range of departments not only meant I got to see a variety of things and contribute in a variety of ways, but it also meant I got to meet and befriend many people. Although my work at the hospital has been important to me and, I think, character-building, it is the people that I will remember. It is the people that I will miss. Thank you... for everything. You know who you all are, so I won't embarrass anyone by mentioning names. The phrase, “so much to do, so little time” comes to mind though. May and I were swamped with invitations to visit people's homes or have dinner with them and unfortunately it just wasn't possible to fulfill them all. It was very flattering to be extended so many invitations, although I am not sure I deserve half the amount of kindness that I have received here.

This has been without a doubt, the most challenging, enjoyable and gratifying time of my life. I will never forget Nagasaki Atomic Bomb Hospital and the people who devote so much of their time and energy to it. Nagasaki has become like a second home to me now and I would not chose another place to spend my gap year even if I could. And who knows, maybe I will come back at some point in the future for a visit...

⼦ども - Children

Here are a few photographs of the children who go to the hospital nursery. All of these photos were taken by May with her camera so I can take no credit for them whatsoever. (Where I have listed two names, the latter is the shortened version that we use over their full names).

Ayaka-/Aya-chan:
Aya-chan is the oldest child at the nursery. Last week, while playing with a piece of my hair, she asked "why is your hair yellow?". Very good question, Aya-chan. Unfortunately, even if I were able to explain in Japanese, I think the concept of genetic inheritance might be lost on a four year-old. Still, I think she has a lot of potential.

Tatsuhi-/Tabo-kun:

Hiroto-/Hiro-kun:

Reina-/Rei-chan:
Hiro-kun and Rei-chan are siblings. Watching Rei-chan play, you can tell she has an older brother. She's forceful, stubborn and a little rough. Oh, and everything is a competition. Yeah, I can relate to that, having grown up with two older brothers myself.

Yuto-kun:

Yuna-chan:

Rintoro-/Rin-kun:
May did well to get a picture of Rin-kun that isn't a complete blur. He never stays still. You have to watch out for him because he seems to like climbing on things and then jumping off them, and he'll happily use you as a prop in his never-ending obstacle course.

Haurka-/Haru-chan:

Yukika-/Yuki-chan:
It was a miracle to get a photo of Yuki-chan where she isn't crying. She doesn't like May and me, so cries for about 90% of the time we are there. The 10% when she isn't crying she is usually laughing at Hiro-kun pulling faces at her.

Tateki-kun (with Re-chan):
Tateki-kun is the most quiet, gentle little boy that you will ever meet. What's funny is that his Dad (who is a doctor at the hospital) is exactly the same.

Tateki-kun & Yuna-chan:

Kanja-san

I met a terminal cancer patient yesterday. It was only part way through a wonderful conversation with her that she told me her diagnosis. I didn`t really know what to say, so I just said that I was sorry and that it sounded like she had had an amazing life. She told me she had traveled to 25 countries, including England three times, and China, where she taught English. I found myself thinking about her last night and I regretted not learning more about her when I had the chance. Today though I found out her name and the date of her next treatment at the hospital. I have also loosely arranged to get a little time off work to go and see her when she is next here. I feel like I should buy her a gift or something, but what does one buy for someone who is dying? I can`t even give her food because she has no appetite due to all of her medications. Maybe I should just give her as much of my time as possible….?

50 Days To Go

Today marks only fifty more days left of my placement in Nagasaki. Can I hear a "woo!"?

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I am going to Oita this weekend with May. More on this when I get back.

整形外科 はだいすき - I Love Orthopedic Surgery

Nothing can make my day like watching a fractured clavicle being screwed back together. I finally got to watch some seikei geka (orthopedic surgery) today. I had been waiting for this for four months and it was certainly worth the wait. There were scews and titanium pins and electric drills and screwdrivers and wire cutters... They actually bored the grooves into the bone for the screws! Come on, how awesome is that?! Oh man, it was excellent. To quote Christina from Grey`s Anatomy, it was "like candy, but with blood, which is so much better!"

I love Seikei.

ぼねんかい - Bonenkai

It was Bonenkai (the hospital end of year party) last Friday night. There is no denying that May and I looked great. She wore a green dress that she had bought on Wednesday and I wore a red top that I'd bought the week before; Our hair was pretty; We had make-up on. All of these things were massive improvements on how we normally look at work – tired, uniform-clad and a little sweaty from all the bed-making. I think we surprised people a little actually. "Wow, they scrubbed up well, didn't they?" It turned out to be as formal an occasion as people wanted it to be - some of the staff wore suits, some wore jeans - so May and I felt nice and comfortable somewhere in the middle.

The party was at the hotel that is right next to the hospital. We pass it every day on the walk to work and it turned out to be very nice indeed on the inside. One thing I didn't like about the evening was that you had to pick your seat number out of a box at random, meaning you could wind up sitting next to complete strangers. That was half the reason for doing it, also there was a raffle at the end of the party based on seat numbers. It didn't really matter though because Kumiko-san arranged for May and me to sit with her at table 7 by talking a few members of staff into switching with us.

Once seated, the food promptly started to arrive, all of which was delicious. There were a lot of dishes that I didn't recognize, but that has never stopped me before from digging in and it didn't then. There was quite a lot of debate between a few of the doctors at our table over what the English name was for the meat in the soup. We had everything from 'seagull' to 'whale' put forward as suggestions. I think it might have been goose, but who knows?!


Part way through the meal, the performances started. Half a dozen or so of the departments gave a 5-10 minute performance and the senior members of staff had to judge the best for a prize of ¥50,000 (£214 – the same amount May and I get per month from the hospital). After the Kumamoto trip, I knew what to expect: Semi-nudity, group-participation and on-stage consumption of alcohol. Oh, and also wigs and cross-dressing. Needless to say, it was very entertaining. Mariko-san dressed up as a reindeer and threw a mango at a doctor in drag, with the aim of him catching it on a fork. He managed it two out of four times, in case you were wondering. Oka-san was up there, Nakashima-sensei and Imamura-sensei too. You would never think that such respected doctors are so willing to make complete fools of themselves in front of a room full of their work colleagues and friends, but apparently it is the complete opposite. Anyway, 4F won. I can't even bring myself to tell you what Imamura-sensei had to do to get the victory for his floor. *Shakes head in disbelief*. All I will say is that it involved a dominatrix. Enough said.

A sample of 7W's performance:


Yamaguchi-san (assistant nurse, 6E) came over to our table part way through the proceedings and gave May and me each a present: two pairs of tabi (Japanese split toe sock). I had yelped with delight at the inter-departmental volleyball tournament a few weeks ago when I had seen her wearing the most beautiful tabi I had ever come across. She obviously took note. You gotta love Yamaguchi-san :-)

Kumiko-san was very drunk by the time the party ended at 10:30. It was quite funny to watch her giggling to herself and tripping over her own feet. She asked us to forget this occasion in the future and although we won't be so cruel as to bring up her embarrassment again, there's no way I could forget her singing "All I Want For Christmas Is You" over a sobering cup of coffee in Mos Burger after the party.

Bossy Me

I actually got to be somebody else's boss on Tuesday. Okay, sure, it was to a fourteen year-old high school student doing her work experience at the hospital, but still. It felt great. I got to order her around a bit when we were making beds but then, showing that I can also be a very nice boss, arranged with the chief nurse on 5W for me to take her on a quick tour of the hospital. I had forgotten what it is like not to feel as though you are at the bottom of the pile. Shame she was only here for one day.

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Bonenkai party tonight. Very, very excited.

New Schedule

There are only two new departments in my revised work schedule for this month: the nursery and the operation room. I worked in both of them for the first time last week, so I can tell you a little about them now.

Before my timetable changed, I worked on the wards every day of the week. Now, with the nursery on Wednesday mornings I have a break from that, a 'weekend in the middle of the week' as May called it. It made a huge difference. How could it not have? Instead of changing bed sheets, folding towels and making oshibori, I am playing with a dozen children under the age of five. They were all very cute and very shy at first, but after about half an hour they were jumping all over May and me – literally – and trying to out-do each other in impressing us. The teachers were great too; they didn't even laugh when they had to show me how to change a nappy.

The highlight of the morning was watching the children's Christmas concert rehersal. I felt a little sorry for them though. They must have been petrified performing to a couple of foreigners instead of their parents. To my surprise, they didn't show any more fear than you might expect from a toddler singing a solo to an audience. It was a great little show. The costumes were wonderful too. And because this was a Buddhist Christmas concert, there was no mention of the birth of Jesus or telling of the nativity story – as you would expect – just lots of singing about Christmas time... and food, for some reason. I can't wait to go back there on Wednesday.

Second, the operation room. You're probably wondering what work two un-trained volunteers could possibly do on the surgery floor. Unfortunately for me, it turned out the answer didn't involve anything inside the theatres. We were doing behind the scenes stuff – packaging sterile equipment mainly, for both the OT's and the wards. I thought it was quite satisfying in a way, knowing that this medical equipment was soon going to be used by a surgeon or doctor. Maybe I was grabbing at straws though; I wanted to be observing surgery.

Anyway, that's about it. My timetable will change again come January. I will no longer have a free Wednesday afternoon but will be working in Nutrition and then Radiology. Although I will obviously miss my free afternoon – especially considering that is the only time I have been able to watch surgeries so far – it will be nice going back to Radiology. I already miss it after only a week without it. There's such a great atmosphere there, one that seems to be unique to Radiology. Plus, May and I have made some good friends there. Matso-san stands out for both of us. He is a similar age to us (he's 24) so we feel like we're on a similar level to him. I am the youngest employee on the hospital staff so, according to Japanese culture, everyone else is essentially my boss, including May. Matso-san treats us more like equals though, maybe because if it weren't for us, he would be the youngest on the staff. I also miss the chief Radiologist, 'Ojiisan' ('Grandfather' – not his name, just what everyone calls him). He shows me the coolest x-rays, MRI's and CT's that he can find and then lets me try and work out what they are of. At least we will see all the Radiology gang at Bonenkai on Friday. Yay.

げか 2 - Surgery II

I went back into surgery on Wednesday. It was only the third time I have been in there but it felt like the hundredth. I feel like I have been watching surgeries all my life, but each one is still just as amazing as the first one I saw.

I watched two operations on this visit: a Cholecystectomy (removal of the gallbladder) and a skin graft.

Cholecystectomy:
This was an endoscopic (or laparoscopic) procedure. Several small incisions are made at strategic points on the patient's abdomen and then the surgeon detaches the gallbladder and pulls it out through one of the holes. This particular patient had a rather bad case of gallstones, so his gallbladder was very enlarged. It was about the size of a pear, and the incisions are roughly the size of grapes, so there was quite a bit of tugging and twisting when it came to pulling it out. It reminded me of birth, only the result isn't a cute baby but a diseased sac of bile. Oh, speaking of bile, the surgeons accidentally punctured the gallbladder while they were detaching it from the liver, and this caused some of the bile contained within to gush out into the patients abdominal cavity. It was quite a sight!

This procedure was particularly impressive because the surgeons can't see anything they are doing directly. They have various long instruments stuck into their patient, which they are enthusiastically moving around, thrusting them into the far corners of this poor man's stomach, all time while looking at a TV screen. It must take a lot of practice. Obviously.

Skin Graft
Now this one was very interesting indeed. Whereas all the other procedures I have observed have been fairly routine, a skin graft can never really be routine, can it? I mean, if you need some of your skin replacing... how often does that happen?

The patient had had a malignant melanoma on her foot. The cancer was very aggressive so the dermatologist had to remove a lot of skin from the foot around the tumour to ensure there wasn't a single cell of it left that would spread. That happened several weeks ago. Now, the patient was well enough to undergo a second surgery to repair some of the damage sustained to her foot as a result of the first surgery. A large section of skin was removed from the patient's abdomen – about the size of a mango, to continue the fruit sizing system – and while an intern and resident took to sewing up this huge hole, the chief of dermatology started preparing the skin for grafting. This involved carefully cutting off the inch of fat – which is a delicious, bright yellow colour by the way – that was present and then smoothing the underside of the skin by cutting away any imperfections. When she was finished, the skin looked so thin and shrivelled I was just hoping that it was stretchy, otherwise it would never cover the wound. It turned out to be remarkably stretchy; The skin really is an amazing organ, you know.

Once the skin was loosely attached with just enough stitches to hold it in place, a blue dye was injected into the tissue around the would, presumably to track the blood flow to the new skin over the next few hours/days. That's when it happened.... the foot moved!!! Ha! The surgeon stopped what he was doing and gave a rather amused look to the anaesthesiologist, who quickly made a few adjustments to the station at his end of the table. Aw man, the foot moved.... awesome :-)

Truffles & Blood Clots

With too many truffles to handle even between the two of us, May and I decided to hand some out to a few of our friends at the hospital. This included our friends in Pharmacy and Radiology, Kimura-san, Kumiko-san, Oka-san and Nakashima-sensei. Everyone was really impressed, exclaiming "Oishii!" ("delicious"), and I think they they won us a few brownie points too. Now we're not just the GAP volunteers, we're the GAP volunteer who give them confectionery. Who couldn't love us?!

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Ide-san, the woman who met all of the Gappers in Tokyo back in September, came to visit Nagasaki last week to check on May and me. Since everything is fine, it was a short, concise visit, only lasting for more than an hour because we broke for lunch. She gave us a piece of advice though that has really stuck with me: be less shy and more active when it comes to asking for more things to do. She said this in the context of asking to watch a birth, but I have already applied it at work in a different context. Yesterday in the Test Department I asked if I could help take the clots out of centrifuged blood - something I see the other lab tech's doing scores of times a day. They didn't even hesitate and handed a blood-filled test tube and a tooth pick each to May and me. They were so impressed they gave us our tea break early and then let us leave for lunch early too. Ide-san's advice really worked! I wonder what else this could lead to? With less than three months to go now, I really have to try to make the most of this.

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I watched surgery again last week. I didn't mention it before because I took May in with me so we only stayed for an hour. She was very impressed but said that once was enough. Me? I'm going back in this afternoon. It will never be enough :-)

ふくふぐ – Happy Fugu

Well, I am alive. The fugu dinner was excellent and, given that none of the attendees died, could be considered an all-round success. It was actually a retirement party for Hamano-san, the lady who works in the Medical Office where May and I spend Friday afternoons 3-5pm. It is so sad that she is retiring; she is like a mother to everyone in the hospital, including all the surgeons who use the office as a break-room. It was an honour to be invited to her retirement dinner, it really was. I am going to miss her when she leaves at the end of December.

The meal consisted of fugu sashimi, then fried fugu, battered fugu, fugu soup and finally, fugu risotto. The window to the tiny little restaurant we were dining at doubled as an aquarium for the (live but soon-to-be-dead) fugu; by the time our party of six was done with all that food, I kid you not, the tank was half-empty. Given that each one of those fish contained enough poison to kill 15 fully grown men, I must commend our highly skilled chief separating the 'safe' parts from the 'deadly' ones. The battered fugu tasted remarkably like battered cod from the chippies back in England, so that obviously had to be my favourite. We fried the pre-sliced chunks of fish on little grills in the centre of the table, which wasn't anything special in itself but what was endlessly entertaining, the pieces of fish were doing that post-mortem death-twitching thing. They kept twitching for about five minutes too. I thought it would last only a few seconds after death but apparently not. They were really strong muscle contractions too.... amazing.

Here's my plate of sashimi. The sashimi is the pale pieces of meat laid out to cover the plate; the white and grey pieces in the middle are some of the fish's skin. Yum. And yes, my lips did go quite numb after just a few pieces. Way to go, chef!


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I got my new work schedule last week. Monday and Tuesday are the same as before, but here are the changes:

Wednesday
am. Day Nursery
pm. Free time

Thursday
am. Pharmacy
pm. Nurses Station

Friday
am. Nurses Station
pm. 13:00-15:00 Operation Room
15:00-17:00 Medical Office

Also, starting in January after my Japanese classes finish at the Brick Hall, we won't get free time on Wednesday afternoons but we will spend 13:00-15:00 in the Nutrition Section and 15:00-17:00 back in Radiology. Overall, these changes are pretty pleasing, although I don't know yet what May and I will be doing in the new departments. I'll let you know.

3か⽉ – 3 Months

Well, I have made it to the half way point. Today is twelve weeks since I came to Japan. Three months down, three to go. I don't think the enormity of being half-way through my placement has hit me yet.

Over the past few weeks in particular, May and I have really bonded. She is remarkably similar to me, which does mean however, that she occasionally annoys me. Most of the time though, we spend laughing together. Yeah, we get a lot of stares from people at work, let me tell you. She has become a very dear friend to me and one I will always think of fondly when I remember my time in Japan. We have already made loose plans for me to visit her in Vancouver and for her to visit me in England at some point in the future. Man, I'm going to miss her. Although I am excited about finishing my placement and going home, it makes me sad thinking about leaving May-chan. Her nickname among her friends back in Canada is 'Amazing', as in Amazing May; on the same theme, she gave me the nickname Wonder Lily. We could totally fight crime.

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This week is the last of my current work schedule, the one May and I have followed for the past three months. We still don't know which new departments we will start working in next week (some of our bosses are having a meeting today, I think, to decide) but we are feeling quite optimistic about the change. Of course, I will let you all know where we end up.

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Tonight is Fugu Night. I am so excited! I'm going to try fugu at last. I remember seeing that Simpsons episode as a child, you know, the one where Homer demands fugu at a Japanese restaurant and then thinks he's going to die after eating it, but then doesn't. That episode has stuck with me all these years, so I am really determined to go ahead and seize this opportunity. Also, I promised my cousin that I would try it. This is for you, Greg!

わたし の しゅうまつ- My Weekend

I had a really great weekend, maybe the best so far since coming to Japan. It started off with lunch at Ezoesan's house with May. Ezoesan is a now-retired nurse who used to work at the Genbaku Hospital and who befriended May and me back in September. It was possibly the best Japanese meal I have had. It was really wonderful. Exquisite, even. Also, she showed us how to do the tea ceremony. For the first time I felt I was getting quite deep into Japanese culture, which was a nice feeling.

The opera on Saturday evening was fantastic too. It wasn't a performance of the entire Madame Butterfly opera, but kind of an ensemble. There were three main vocalists, two soprano's and a tenor (the tenor and one of the soprano's were Korean and the other soprano was Chinese), as well as three pianists, an violinist/violist, a clarinet player and a group of chorus singers. The show opened with 18 kimono-clad women on stage singing the chorus. It was truly amazing. The clarinet player was the best I have ever seen. I was glad to see his talents were being rewarded with an excellent solo. Of the two soprano's, the Chinese woman was the most skilled, but the the Korean woman, wow. Her voice... her voice just melted into you. Her name is Chun Sonmi, if any of you want to look her up. My favourite performance of the evening was the tenor's rendition of a traditional Korean folk song. He was clearly enjoying singing it, which makes all the difference.
Sunday started bright and early with an inter-departmental volleyball competition at the hospital. May and I went with the intention of just watching and cheering on our friends but, well, one thing lead to another and we ended up playing in a match. I had never played volleyball before in my life and there I was is a tournament game. Naturally, I was appalling. Fortunately, the game didn't last long and May and I didn't let ourselves get dragged into another one for the rest of the day. We enjoyed the cheering part, and a lot of the hospital staff brought their kids along so we got to play with them too.

After much hilarity during an MSN conversation with my friend online and after running 10km 2 minutes faster than my previous time (woo!), I had my monthly phone call home. Although one of my brothers and my Mum couldn't be there, I still had a lot of fun talking to two of my siblings and my Dad. There was lots of laughing, initially at the huge time delay between each person finishing a sentence and the other hearing it. Speaking to them made me realise something: I am happy here. Before I was fine, but now I am happy.

I only have a four day week at work this week since it is a national holiday in Japan on Friday. May and I have plans for pretty much every minute of the three-day weekend. I'll talk more about that later though. Oh, one last thing. May informs me that today marks 100 days of our placement remaining here in Nagasaki. That doesn't sound like a lot does it? That's all for now; Got to get back to work.

Hamanosan, my supervisor on Friday afternoons, just handed me and May tickets to see Madame Butterfly tomorrow night. Awesome. I am going to the opera tomorrow, woo! And where better to see Madame Butterfly than in Nagasaki?

We love Hamanosan. She`s become like a mother to us. If we ever have a problem she will be the first person we go to.

げか - Surgery

Phew! What a week it has been. My first surgery was awesome, as was the Kumamoto trip, although for drastically different reasons. I'll talk about Kumamoto in a later post, I promise.

So there I was, last Wednesday, the day of my first surgery. I was met by one of the female surgeons who took me into the changing room to get into my surgical scrubs, cap and mask. Even that part was exciting. She then took me through the surgical floor to O.T. 5, where I had a few minutes to just look around in awe at all the cool equipment and medical stuff. Nakashimasan (the vice-president of the hospital, who took May and me to the Viking restaurant back in October) arrived and he told me a bit about the patient: 6 year-old male; blood type AB+; suffering from sleep apnea, difficulties eating/gaining weight, a concave chest and heart problems as a result of this; will undergo tonsillectomy and adenoidectomy. Basically, his tonsils and adenoids were so big that he couldn't swallow, that's where most of his medical problems were coming from. This tiny little boy was brought in, obviously pretty scared, but the anaesthetists were great and soon calmed him down. It took quite a long time for him to fully fall asleep though. Nakashimasan explained that they were being particularly careful with the anaesthetic because he was a child.

With the patient under general anaesthetic, the surgeons got to work. The main thing they were worried about was bleeding. They don't use sutures for a tonsillectomy so they have to be certain that they have stopped all the bleeding (using what is essentially a soldering iron) before they wake the patient up. I was a little surprised at how rough they had to be to get the tonsils out. They used a 'snare' (wire loop) and pretty much just pulled them out. From start to finish, it was about 1 hour 30 minutes. That's 90 minutes of pure enthralment from my perspective.

After the little boy was moved out and taken back to his Mum, Nakashimasan gave me a proper tour of the surgical floor. I got to peek inside the other four operating rooms, all of which had surgeries going on in them. I also spent a few minutes observing a skin tumour being removed from a woman's scalp, which was very cool. I wondered how something like that gets noticed though. I mean I could only see it because her head had been shaved. Ordinarily her hair would have covered it, right?

Anyway, we headed back to OT5. A second patient was brought in. Two surgeries in one day – I couldn't believe my luck! This patient was a middle-aged man with a visible tumour in his neck: a tumour of the lymph gland. As you probably would have guessed, he was in surgery to have it removed. The doctors didn't know if it was malignant or not, but regardless, nobody wants a lump the size of a golf ball sticking out of they neck. This second procedure was way cooler than the first. The point at which I realised this was when the surgeons were in the process of cutting out the tumour, tying off blood vessels as they went – something that looked very satisfying to do indeed – and a wonderful gloop of lymph oozed out of it. Imagine really thick cream, but more yellow, and you've got lymph. It was disgusting but so, so interesting. Apparently, this tumour was actually contained within a lymph-filled sack, hence the seepage. Cooool.

The second surgery only took about an hour and after that, alas, I had to leave. I was really tired though, after standing up concentrating for three hours straight. My body was tired, but my mind was buzzing. It really was amazing. It all felt so natural, you know, like it was natural for me to be there. This wasn't just some once-in-a-lifetime experience; I could see myself doing this every day as my job. Ah, I am still so excited about it a week on. I might being going into surgery again this afternoon but Nakashimasan is at a conference so I need to find the female surgeon from last time. I'll let you know as and when I make it back in!

おどろき- Surprises

Surprise Number One: Today, in approximately twenty-five minutes, I will be watching my first ever surgery!

Surprise Number Two: Over the next four months I will be watching many surgeries, perhaps as many as one per week, and of all different types. My hospital doesn't have a cardiology or neurology department - yes, I did ask! - but it does have an excellent orthopedic department. Do you know how cool an orthopedic surgery is going to be?!

Surprise Number Three: I am going to Kumamoto this weekend, my first trip outside of Nagasaki. There's a Kyushu-wide Red Cross Sports Competition being held there on Sunday, so the hospital is arranging for May and me to travel down there, as well as putting us up in a hotel and providing us with meals. We have to pay ¥5000 for this but, believe me, this is a bargain. Although we're only going to watch, it will be great cheering for the Nagasaki team, as well as getting to know some of the other hospital staff better. Oh, and Lucy and LeeAnna, two of the other Gapper's we met in Tokyo are placed in Kumamoto, so May and I will get to see them again too.

Surprise Number Four: I can't tell anybody this one yet, but for those it will affect - hee hee - it's going to be great.

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Feeling good.

やっきょく- Pharmacy

At the end of November my timetable at work is due change. I will still spend half of every day in a nurses station, but the departments in which I work for the other half will change for the latter three months of my placement. This means I will no longer go to the beloved Pharmacy on Thursday afternoons or Radiology on Friday afternoons. I feel a little sad about this because I have made some good friends in these departments and I enjoy the work there. On the plus side, I won't have to go to the Medical Matters section first thing on a Monday anymore. No more lugging patient's files the size of encyclopedias for three and a half hours at a time, yay.

When I first discovered that my whole working week was to be transformed so drastically, my instinct was to worry. (What a surprise, *eye roll*). Now though, I am getting quite excited about it. I have various sources of information in the hospital, and in terms of which new departments I can expect to spend half of my week in, overall things look good. I don't want to say too much on this now because I kinda sorta have a few surprises up my sleeve that I don't want to let slip yet. Hee hee. I know something you don't know!

Anyway, I know I have mentioned the Pharmacy a few times as being my favourite department, but I haven't really explained why. Now that I only have four more afternoons there - yikes, is it only four? - it seems about time that I list a few reasons why I like it so much:
1. I'm together with May, so we can chat and I don't have to worry as much about understanding Japanese because she is essentially my interpreter.
2. We get to sit down for the entire time. Believe me, this is a God-send after a hard morning on the nurses stations.
3. Most of what we do involves packaging medications, like this...

...folding leaflets, and occasionally mixing pre-measured medicine. None of this is particularly difficult work, but is occupying enough that we don't get too bored and not too distracting so we can still talk.
4. The staff in the Pharmacy are really friendly and very appreciative of our work. They even make us origami.

5. The staff in the Pharmacy bring us tea and cakes once we have finished all the work.
6. We are allowed to leave early if we finish all the work set. We do this every single week.

So there you go, my work in the Pharmacy in a nutshell.

2⽉ - Two Months

Well, another month has passed. That's two down, four to go. Looking back, the second month was a bit easier than the first. Perhaps this is because everything is now familiar, perhaps it's because of the babies on 5E. Although, having said that, I seem to have developed new fear during my second month in Japan: stairs. Japanese stairs are really steep and tall (you saw the ones at Suwa-jinja!) and are made of brick, and I'm afraid that if I fall down them I will break my neck and that will be the end of me. I'm even having dreams on this theme. I look forward to nice English, carpeted staircases.

On a much brighter note, yesterday I got to handle my first human organs! Woo. Sure, they were from a recent autopsy rather than a live patient, but that actually took the pressure off a little and made me less worried about dropping them on my shoes. My friend in the test dept. just kept on handing me body bits, which I prodded for a while until he handed me the next one. I could tell what some of the organs were but some were completely indistinguishable (they had already been 'autopsied' – cut up). I was playing around with one particular piece of dead person and couldn't figure out what it was, so I asked: the patient's rectum-

8-I

-Right. Okay, I'm just gonna put that one down now. Next? I was quite proud of myself for putting my hands in a jar filled with formaldehyde and all the internal organs of a now ex-patient. I hesitated at first, but then thought, 'hey, when is the next time I'm gonna get the chance to do this?' I answered my own question with, 'probably next year when you start medical school' and decided it was too long to wait. “Hand me the gloves,” I said. The organs were actually less scary once I had touched them. After feeling them they just became rubbery bits of meat rather than parts of a human being, and that was easier for my brain to handle.

Anyway, back to the point of this post. I have passed my two month marker. Next target: Three Months, aka Half Way.

Suwajinja

I have been unbelievably busy this past week or so. I'm just about getting enough rest, but I have had practically no time to write anything substantial for this blog - sorry. Hopefully, this quick post will keep you all occupied until I find some time to write a real post.

May and I went to Suwajinja Shinto shrine on Saturday. Much to our dismay however, we had to climb the Tallest Set of Stairs in the World (see above) to get to it. This photo wasn't even taken from the bottom, but part way up.

The great ascent was worth it though; The view was amazing.

The shrine itself wasn't half bad either.

And we found an old-fashioned well to play with while we were there. Yay.

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After the shrine we headed to the Fukusaya Castellla Shop, which has been making and selling castella cakes since 1624. We split the cost of the smallest one they did and had it for dessert after our first attempt at home-made okonomiyaki, which I have to say was a remarkable success.