PINPIN KORORI

Japan and America are facing many of the same issues in terms of health care policy.  Both countries are grappling with the rising cost of health care.  According to Bloomberg:

Japan introduced an affordable health system in the 1960s to broaden access to acute care when tuberculosis was the nation’s top killer. Cancer and cardiovascular disease now are the most common causes of death. Those are more complicated to treat, so the system is overloaded with patients and the cost to the government is escalating.

As the drain on national health care funds increases, so too do the benefits decrease for those who will need health care in the future.  In a nutshell: event though younger generations pay into funds like Social Security or national health care, when it comes time for them to reap the rewards of those contributions, there will no longer be enough to subsidize everyone's care.  In Japan, people born after 1955 will lose out on benefits.  In the United States, Social Security will be depleted by 2034.  

PUTTING A FACE ON THE ISSUES

Last week Bloomberg published an interesting piece on elderly care in Japan. It explores the ethics and economics of aging through the story of one woman, Hisako Miyake, who is now 96 years old. Miyake is bedridden and has a feeding tube surgically inserted into her stomach to keep her alive. She also has dementia, and made no record of her wishes concerning her care prior to her deterioration.  Her granddaughter, who wrote the article, is one of millions who will lose out on health care benefits when it's her turn to cash in.

With more people living decades past the traditional limits of life expectancy, families and medical professionals are having to weigh prolonging patients' lives against their quality of life. Quality of life is a frequent refrain when discussing end-of-life issues; however, this article also brings up quality of death, or allowing people to pass with dignity and without pain. More and more Japanese people express a desire for pinpin korori, defined as living "long, healthy lives and to die naturally without suffering from illness." The question is, is it possible to avert suffering if drastic measures (e.g., the surgical insertion of feeding tubes) are being implemented to keep people alive?  

I LOVE OKINAWA

Back in the days when my parents first got the Internet, there was this program you could download that let you choose from vast libraries of photographs to use as your desktop wallpaper.  There were all sorts of themes: travel, forests, animals, black and white shots, etc.  My favorite was a beach with cream-colored sand and water so blue and clear it put chlorinated pools to shame.  As beautiful as it was, I could never imagine actually visiting such a place.  First of all, my family never vacationed at the beach.  The family joke was that my dad would take us to resort areas and no one would even bring a bathing suit. Other families went to places like Cancun to swim and work on their tans; we went to visit the ancient ruins that were on the beach, tented in hats and long-sleeved shirts to reduce sun exposure.

Second, it seemed unreal that such a place existed, when my primary reference for the beach was the Gulf of Mexico, whose water is more of a brackish brown than a tourmaline blue thanks to the mud churned into it by the Mississippi River.

The Gulf of Mexico.  From www.weathertemperature.net.

So you can imagine my shock when I went to Okinawa for a few days, and it looked like this:

Zamami, Okinawa

A LITTLE BIT OF CONTEXT

Okinawa is dramatically different from the rest of Japan.  The islands lack the four distinct seasons that are so highly prized by the Japanese.  Since the territory lies at the same latitude as northern Myanmar, the weather vacillates between hot, hotter and hottest.  The people in Okinawa are laid-back in a manner characteristic of cultures that live in hot climates.  We saw scads of men with long hair, and men and women with prominently displayed tattoos.  We also observed a fairly interesting trend in which all the businessmen were attired in dress slacks and Hawaiian shirts, a colorful diversion from the black trousers-white dress shirt uniform in mainland Japan.

Okinawa also possesses a unique history among the prefectures of Japan.  The Meiji government assumed control of the islands in 1879, designating them a Japanese colony.  Much of the Ryukyu culture indigenous to the islands was systematically suppressed; however, some of the aesthetics (architecture, art, etc.) remain.  There are several movements concerned with the preservation of Ryukyu culture, which some feel is perilously close to dying out.

During WWII, the islands were the site of the bloodiest conflict in the Pacific Theater.  Over 200,000 people (soldiers and civilians) died in the Battle of Okinawa.  In case of an invasion by the Allies, civilians had been trained by the Japanese military to commit suicide rather than be apprehended by enemy soldiers.  The Okinawans were considered to have too much valuable information about the Japanese military, and were therefore liabilities if they were captured or questioned.  

On July 4, Paul and I briefly visited the Peace Memorial Park for the Battle of Okinawa, which was extensive and beautiful.  Both of my grandfathers were in Okinawa during WWII; one of them served in the U.S. Navy on a ship stationed offshore.  As we walked around, I tried to imagine what it must have been like for these young soldiers, most of whom had never left their hometowns, to be stationed someplace so exotic yet dangerous.  My grandfather told my dad that while he was in Okinawa, a typhoon hit the flotilla, sinking a number of ships.  For a man from the landlocked state of Kansas, he must have felt really far from home.

Names of the dead, Peace Memorial Park.

Today, Okinawa hosts a number of U.S. military bases*, straining relations between Okinawa and the U.S., as well as Okinawa and mainland Japan.  There have been numerous reports over the years of military personnel being disruptive, damaging property, and even sexually assaulting local women.  Okinawans want the bases to be moved elsewhere, but the national government keeps dragging its feet.  The level of frustration has risen to a point where some Okinawans are advocating secession from Japan.  

BUT SERIOUSLY, OKINAWA IS AWESOME

Paul and I agreed that it was fortunate that we discovered Okinawa right as we were about to leave Japan, otherwise we would have spent every holiday there and ignored the rest of the country in favor of early morning swims, sunsets, and some of the most incredible stars I've ever seen.  

Our favorite beach for morning/evening swims.

We tried scuba diving for the first time, off the coast of one of the uninhabited islands near Zamami.  I'm not sure what I expected; the closest I'd come to scuba diving was snorkeling in the Galapagos Islands, and though that part of the Pacific is beautiful and filled with an abundance of marine creatures, the visibility is nothing compared to Okinawa.  We could see for what seemed like miles, and the fish were unlike anything I'd ever seen.  Magenta, aqua blue, bright yellow, red, spotted, striped, electric blue, orange, hot purple, and more- I didn't realize that colors like that existed outside of the 1980s.  

Parrotfish. From www.flickr.com.

We glided along reefs, occasionally coming face-to-face with a blowfish or a sea snake, or watch clown fish dart back into anemones.  Mostly, however, the fish didn't seem perturbed by us, and would swim closer to examine the strange black-clad creatures swimming past.  The only thing I can liken it to was being in the best aquarium imaginable...but a billion times better.  

Though this is probably an aquarium, it's not unlike what we saw while diving.  From commons.wikimedia.org

The dive itself was short- only thirty minutes- but our guide was really kind and offered to loan us the masks and flippers for the day in case we wanted to go snorkeling later.  We did, and we ended up finding a huge reef that we spent over an hour paddling around, watching the kaleidoscope of fish pass by.  I'd be studying a certain area, and then look away for a moment, and when I'd look back again a second later, the reef would have changed completely.  The coral was still there, and the anemones, but the creatures surrounding me would be entirely different.  Often I'd suddenly realize that schools of fish were swimming around me, causing the water to shimmer even more with their bright scales.

Leaving Okinawa was a wrench.  The scuba diving alone was one of the top 5 experiences of my life.  However, it's all the more incentive to return to Japan.  Next time, though, I may never leave.  

Near Ama Island

*There's also a surprisingly large Japanese military population in Okinawa.  When we landed in Naha, more than half of the tarmac was filled with planes featuring the hinomaru (the Japanese flag).

THE LAST WORDS

As many of you who read this blog know, I love my students.  What's more, I love the outrageous things they communicate through speech or writing.  Now that classes are over, here are the last gems from my time teaching.  Here's hoping they keep in touch via email and send me fresh material- I'll really miss these great perspectives. 

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Grading first year papers, I've noticed a disturbing trend wherein they all write about themselves in third person. But not in an acceptable way like, "Elizabeth writes a Facebook post." Instead they use the pronoun "it." As in, "It puts the lotion in the basket."
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Second years have to write a presentation detailing 3 things you can do with a certain object. The paper team wrote: "Secondly, you can clean a dirty butt. This paper is very important to me in my life."
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First years had to write draft presentations, which I am now correcting. The recurring themes are hobbies, pets, and club activities. These stood out:

1. One kid wrote an entire presentation on Germany and the Berlin Wall, and killed it.
2. Another wrote about a trip to Hawaii she and her mother took last summer, just to see EXILE (a famous pop band). Very nonchalantly she wrote, "After the picture, we ate dinner with them."
3. "My dog is woman. She is not marrying."
4. "Hello, everyone. I'd like to talk about my abacus because I like it."

Then this happened: "I like western movies. I think that the best movie is The Karate Kid."
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A couple of my kids came up and squeezed my arms. One of them said, "Mm! Marshmallow."

Guess it's time to hit the gym and officially reclaim my Michelle Obama guns.
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Some miscellaneous observations:

Next, Sandeul [a Korean pop star] has a beautiful voice.  He resembles a duck.

I want to tell you about Takatori Junior High School.  There are many insects.

The music makes a woman having a long hair a concept.  I intended to grow hair to listen to the music.

Q: If you could have dinner with anyone living or dead, who would it be? What would you talk about?

A:

"It is a poisoned dinner."

"I chose living.  I think that it is a fish."

JAPAN IS STRANGE. SOMETIMES. A LOT OF THE TIME.

When you are on the outside of a culture looking in, there are often things you find strange.  Not in a "How peculiar, you drive on a different side of the road" kind of way, or even in a "I don't get that joke" way.  There are simply fundamental differences in what some people consider comprehensible, compared to the rest of the world.  Below are a few Japanese examples of this discrepancy.  They are by no means an exhaustive representation of everything that is out there.  However, they all made me shake my head and say, "What?"

Kikkoman Soy Sauce Ad

The Diarrhea Song- lots of great gestures, as well as some perplexing subtitles. 

Scary Japanese "mannequins." 

This video I call "Nice Peace." There are many things I appreciate about this video: the costumes, the lyricality of the music, the unwitting offense that is given when this guy starts giving the two-fingered salute instead of the peace sign.  The song is fairly catchy, too.  

Standing outside an Osaka subway station last year, I watched as a man in blue coveralls walked by with this cat on his shoulder.  My friend and I were in the middle of having a coffee, which we hurriedly abandoned to follow this feline Pied Piper and find out what was going on.  The man placed the cat on this pole so that people could take photos, and then walked off again.  I like to think of this cat as a more dapper Grumpy Cat.

In another example of cat power, behold, Sir Tama.  Sir Tama is the super station master of Kishi Station in the neighboring prefecture, Wakayama.  Sir Tama (who is actually a lady) is regularly trotted out in ceremonial garb for special occasions.  Many of the stores in Wakayama feature Sir Tama memorabilia, and she has brought in over a billion yen in merchandise and tourism. According to Wikipedia, Sir Tama "is 'the only female in a managerial position' in the [rail] company" that owns the line on which Kishi Station is located. 

This man in Tokyo can sing any national anthem you can name.  We should have told him we were from Norway; instead, he serenaded us with The Star-Spangled Banner.  No clue how the tiger heads fit in to his shtick.   

ELEPHANTS IN THAILAND

Elephants and Thailand go together like Egypt and the pyramids, Australia and kangaroos, or Italy and pizza.  Their ubiquity in art, fashion, advertisements, and even unlikely places like beer bottles, points to their iconic status in Thai culture.  However, chang ("elephant" in Thai) have a fairly dicey history.    

Chang Beer.  From commons.wikimedia.org.

Like Brahman cattle in India, elephants were once honored and revered as sacred beings, trained to fight in wars and protect the kingdom against invaders.  However, as Thailand modernized and began to capitalize on its teak exports, elephants were drafted to work in the logging industry instead.  To do this work, they had to undergo extensive training, in a process called the phajaan.  During the phajaan, elephants are restrained in small wooden cages barely large enough for their bulk and beaten, poked and stabbed for several days until they become obedient and docile.  There's a stomach-churning video of this ordeal here.  

In 1989, the king of Thailand outlawed the use of elephants in logging, but it hasn't prevented people from subjecting elephants to the phajaan in order to make them suitable for work in the tourism industry, giving rides, painting pictures, or simply walking around busy cities like Bangkok, begging for food.  This is tortuous for the elephants, who are very sensitive to external stimuli and require far more water and food each day than can reasonably be given to them in a big city.  The animals become stressed, lonely and depressed, and often die within a few years.  

Feeeeed meeeeeee

At the turn of the 20th century, there were 100,000 (domesticated) elephants in Thailand; today, they number just a few thousand in total.  While it is illegal to kill elephants for the ivory of their tusks, it is permissible to take ivory from live elephants, often damaging their faces and their delicate trunks, creating infections that eventually kill them.

There are a number of conservation groups working to rescue elephants.  One such operation is the Elephant Nature Park in Chiang Mai, which I visited back in May.  The park is the life's work of Lek Chailert, a Thai woman who grew up learning about herbal medicines from her grandfather, who was a healer.  She has adopted almost 30 elephants over the years, and the park boasts several births as well, bringing their herd to 34.  Lek has also started a program called the Jumbo Express, which involves traveling with veterinarians to villages in northern Thailand to bring medical aid to elephants and teach their owners how to best care for them.  

A new baby had been born shortly before we visited the park; it was just 25 days old when we saw it.  There is nothing cuter than a 3 ft tall baby elephant...except for a 3 ft tall baby elephant that plays soccer.    Someone had given the baby, named Dok Mai, a soccer ball, which she enthusiastically kicked up and down the length of her pen (mother and calf are kept in the pen for security; mothers are very protective of their offspring).  It was difficult for even the most hardened observers not to squeal with delight. 

Baby Dok Mai, who was only 25 days old when we visited.

Shower time!

Perhaps the most heart-warming aspect of the Elephant Nature Park is seeing how content all the animals are.  It's reassuring to know that Dok Mai will never face the horrors experienced by other older elephants.  And it's a pleasure to see how these long-suffering creatures finally find peace and proper care.  One elephant who had been used in the logging industry and blinded by her "trainer" is now waited on hand and foot, bathed by volunteers in the river, and fed pounds upon pounds of fresh vegetables and fruits everyday.  She's banded together with two other rescued elephants with similar histories, and the three "besties" are never far from one another.  These kinds of groups offer protection and companionship; elephants are remarkably human-like in the way they develop relationships with one another. 

Hello, humans

While we only stayed for a day at the Elephant Nature Park, they offer longer stints during which you can volunteer to help care for the elephants, and therefore have more time to observe and interact with them.  Incredibly worthwhile, particularly when you consider that a hefty portion of your money goes towards the year-round care of the elephants, and saving up to rescue others.  

Feeding time.  Sometimes the elephants will gingerly take food from you with their delicate trunks; other times you have to place it directly into their mouths.  Elephant tongues are weird. 

THE VIEW FROM THE TOP: CLIMBING FUJI-SAN

"He who climbs Mount Fuji is a wise man; he who climbs twice is a fool." -Japanese Proverb

Fuji-san in May

A Kiwi, an American, a Canadian and a South African set out to climb a mountain.  This sounds like the start of a bad joke, but it's actually the beginning of the tale of how I climbed Mt. Fuji.  Born of a last-minute decision to seize our final moments here and do something epic and memorable, summitting one of the most infamous symbols of Japan seemed like an adequate exercise of carpe diem.  We reasoned that we would always regret it if we didn't at least try.  And so, with lots of research but no physical training, we departed for Shizuoka prefecture, modern age pilgrims paying homage to a venerated icon.   

A LITTLE BACKGROUND

Fuji (or Fuji-san, as it's referred to in Japan) is an active volcano, its last eruption taking place in 1707.  Some scientists fear that another eruption is imminent, and that an earthquake could set off a chain reaction, culminating in an explosion and a possible national emergency.  These grim prognostications haven't deterred the thousands of visitors Fuji receives each year, however.  

A count by the Japanese government estimates that over 300,000 people climbed Fuji last year alone.  They predict that these numbers will rise exponentially this year, in response to Mt. Fuji being named a UNESCO World Heritage Site in June.  The window for safely climbing Fuji is very narrow, from July to August.  Ascending during the rainy season or colder months can be treacherous, and there have been deaths and serious accidents in the off season.  Thus, the mountain is highly congested with human traffic at the peak of summer.  Prospective hikers are warned about queues leading up the mountain, forcing people to wait.  However, local governments are concerned about other repercussions from Fuji's designation as a World Heritage Site as well.  

Although it's Fuji policy to "pack in, pack out" (whatever you bring with you onto the mountain, you take with you afterwards, including trash), many are worried that the influx of hikers will cause the mountain to become filled with trash and detritus.  There's also a concern that the trekkers will have an adverse impact on the trails, causing erosion and rock slides, as well as affecting wildlife and foliage.  To help cope, the park may ask for a 1,000 yen ($10) suggested donation to defray the costs of upkeep, etc.  Given the prominence of Fuji in Japanese cultural consciousness, its preservation is of the utmost importance. 

Fuji has long occupied a place of reverence in Japanese culture, and is the subject of countless works of art, including ukiyo-e (woodblock prints), paintings, and poetry.  Fuji is considered a holy place, and has been a destination for thousands of pilgrims for centuries.  Until about 1872, women were not allowed to set foot on Fuji, as females were excluded from sacred spots around the country.  Today there are four trails leading to the summit.  We opted for the shortest and most westward-accessible route, the Fujinomiya Trail.      

One of Hokusai's "Thirty-Six Views of Fuji." From commons.wikimedia.org.

NOW BACK TO OUR TALE

The Fujinomiya Trail is divided into sections, 1-10, with the summit being number 10.  We began at the 5th station, at 2,400 m.  For many, the point of climbing Fuji is to see the sunrise. Some choose to start from the 5th station and then sleep for a few hours at the 8th station before awakening around 1 or 2 am to start the final climb to the top.  However, we were among the dangan-tozan, or bullet climbers, people who try to make the sunrise by climbing through the night without resting.  We'd been advised that it would take approximately 6 hours for us to reach the top from the 5th station, and 3 hours to descend.  In the end, only 3 of the 4 of us made it to the summit.  One of us managed to make it up in 8.5 hours; two of us took 9.5 hours.  The descent was a whopping 5.5 hours, meaning that in total, we were on the move for almost 15 hours straight. 

Team FUJI at the 5th station.  Ah, look at the hope in those eyes!

As a dangan-tozan, your greatest enemy is not the altitude or the steepness of the trail or the crumbling terrain, or even the cold and wind.  The most difficult obstacle to overcome is fatigue.  We left the 5th station at 8 pm, meaning that the longest part of the climb, between stations 7-9, took place when we were supposed to be sleeping.  As my Kiwi companion put it: "My body is telling me I should be in my warm, comfortable bed right now."  Instead, we were toiling up a mountain in the pitch black, constantly buffeted by the rising winds, struggling to put one foot in front of the other.  I certainly fell asleep while standing up a few times, and any time we stopped to rest or catch our breaths, I'd drop off for a few minutes until it was time to move again.  

To be honest, I don't remember much about the hike up Fuji, I was so out of it.  The night was gorgeous.  The skies were perfectly clear, and the stars made an impressive, glimmering dome above us.  We saw at least one shooting star, and were mesmerized by the lights blanketing the valley below us.  You could distinguish the twist and turns of the trail from the head lamps of the various hikers, slowly wending their way up like ants up an anthill.  The effect was rather spooky; at times you felt as though you were in the throes of a zombie or science fiction film.

Our first big problem struck around station 7.5 (there are two station sevens, "old" and "new").  The vision of our South African team member started to blur, which initially we attributed to the fact that the wind was blowing tons of dirt and grit into our eyes.  However, it worsened the farther up she went, compounded by the fact that the batteries to her head lamp gave out, and she had to slowly pick her way over the rocks in the dark.  However, by the time we reached station 9.5, just a few hundred meters from the summit, she had lost sight in her left eye and couldn't go any farther, and she had to turn back.  Of all of us, she was the most brave in attempting to scale the mountain, and it was incredibly fortunate that she didn't fall or wander off the path.  But even more luckily, the damage to her eyesight wasn't permanent.  We later learned that she had become hypoxic, and that the altitude was preventing oxygen from getting to her eyes, altering her vision.  Thankfully her eyes returned to normal as she descended.

In between stations 8 and 9, I managed to do something to my right knee, that made it painful to bend.  Unfortunately, this kind of flexibility is required to move up a mountain, and is even more essential when going down again.  While I was able to manage the discomfort on the ascent, the descent was pretty grueling and painful.   

Almost to the summit.  Below you can see a huge tract of snow, and to the right, station 9.5.

And yet, despite all the odds, three of us made it to the top, at 3,776 m.  Only one of us made it up for the sunrise at 4:39 am; I and our Canadian team member followed at 5:30 am, after waiting in a queue of hikers for close to an hour.  The summit was cold and beautiful, and the view stunning. We paused for half an hour to explore, give thanks, and take some photos.  Then we took a deep breath, and started to make our way back down again, in the search of food and sleep. 

The summit.

The sunrise.

Finally made it to the summit, 3,776 m. 

Finally off the mountain almost 6 hours later, we made a hasty retreat back to civilization.  Each time I rubbed my eyes or my face in exhaustion, my fingers would come away with a fresh coating of black volcanic soil the mountain had baptized me in, and a full-body stiffness set in as soon as we stopped moving.  Days later, I still can't believe what we did.  Before I left, one of the grannies said to me, "If you can make it to the top, you will have success in the future!" As I gear up for the next chapter of my life, I can't help but hope that this is in fact a harbinger of things to come.  That with a lot of perseverance and a little team work, I'll manage to get where I want to be. 

TIPS FOR FUJI

If this narrative hasn't discouraged you from attempting to tackle Fuji, here are my recommendations based on my experience:

1. Don't be a hero.  Take constant stock of your mental and physical condition as you go up.  If you start feeling dizzy or nauseated, don't force yourself.  Take smaller steps, buy oxygen, and drink lots and lots and lots of water before, during and after.  If your vision becomes impaired or you vomit or lose your equilibrium, turn around and go back down.  The altitude sickness will only worsen as you go up, and you run the risk of doing serious damage to yourself and your health if you continue. 

On the Fujinomiya Trail, there is purportedly a first aid center at the 8th station.  However, when I asked about it, I was told that it wouldn't be open until the end of July.  Even if the center had been open, I can't speak to what sorts of services they would offer beyond bandaging things.  If you were injured to a point where you needed to get down the mountain quickly, I don't know that you would be able to be lifted off or driven down.  Moreover, if you became incapacitated somewhere above or below the 8th station, it could take a good while for help to reach you.  So, better to be safe than sorry.

2. Bring the right gear.  At the very least, this should include layers of clothing (particularly a wind and rain-resistant layer), water, and snacks.  A hat and gloves are essential as well.  The gloves are not just to keep your hands warm, but also to protect you against the rocks and ropes on the descent.  I brought a ski cap for the night, and then a baseball cap for the daytime.  If you're climbing at night, don't forget that you will probably descend in the daytime, so be sure to lather up with sunscreen on the way down- the sun will be fierce.

Head lamps are not optional, and are vastly preferable to handheld lights.  If you think that you can get by with the light from your companions' torches, you're wrong.  Be sure to bring fresh batteries, and back up batteries as well.  

Here's a comprehensive list on what you should bring when you climb Fuji.  

3. Treat yoself. If you're on a budget, don't try to take night buses to and from Tokyo; take the shinkansen (bullet train) instead.  It may be double the cost, but it was the best $200 I've ever spent.  Also, plan on visiting an onsen (or at the very least a hot shower) after you climb.  Massages help too.  Don't be shy about staying overnight, either.  You can make a reservation at one of the many mountain huts and catch a few hours of sleep before moving on.