Back in 1994 I had to visit a country hospital in a small town west of Tokyo where I used to live. I was having problems with a pain in my abdomen. The doctor poked around with his fingers for about 5 minutes then announced, “You have cancer of the pancreas. You have about a month to live.” I was, naturally, speechless. (what exactly do you say when someone you hope knows what they’re doing, tells you that you are going to die?).
I left the hospital with my wife and wandered across the street to the strand that swept past the hospital, east and west, for 20 kilometers of black sand in either direction. It is the very place lined with black pines you see so often in woodblock prints from Japan, with Mt. Fuji looming in the background. Once a stunningly beautiful place. Today the beach is strewn with kilometeer after kilometer of washed up and tossed away garbage, so that’s it’s almost impossible to take a step without treading on some plastic detergent bottle or shard of broken glass or bauble of aluminum beer can.
In all the times I had been here before I had walked around cursing under my breath and stewing with outrage. Why the **** do Japanese have to be so slovenly and apathetic in the way they take care of the land? (It’s like this throughout the country… any illusions that people may have of a pristine, nature-loving society ought to remember that this is one of the most crowded, industrialized countries in the world… there is a reason why they have been so successful)
But that time it was different. As I strolled along, the impact of the doctor’s announcement still fresh, everything seemed utterly beautiful: the way the sunlight glinted on the old bicycle half-buried in the sand; the practical and unself-consciousness of the strip of butyle rubber, bicycle inner tube hanging from the beak of a passing seagull; even the old man, in baseball cap and socks pulled over his polyester workpants hems, who was burning a pile of polystyrene lunch platters and used, wooden, throwaway chopsticks… the black smoke drifted up into the air like a skein of incense, platitudes to the dying god on the horizon. The whole scene took on a gloaming quality, of a world sinking in embers, and each and every element that constituted its existence quietly and desperately held on to the few moments it had left to be.
I stood for hours at the wrack line, my wife beside me, listening to the waves dump and wash away, dump and wash away, dump and wash away…
I had intended to write the whole story about the pancreas cancer diagnosis, but somehow I got mesmerized by my own preoccupation with pretty words… sorry about that… leading readers by the nose is a writer’s misdemeanor.
It’s kind of weird about the diagnosis. The doctor only poked around my abdomen for about five minutes and then pronounced pancreatic cancer. When I got home that day I kept thinking, how could he possibly have known that, just by prodding me? The more I thought about it, the angrier I got, that he would so blithely pronounce my death without doing proper check-ups.
The following weekend I took the long-distance bus into Tokyo, alone and full of trepidation, to be examined by my family doctor. After x-rays, a boron test, blood samples, lots more prodding of abdomen and chest, lots of questions, and then one week of anguished waiting, my doctor pronounced me fit as a fiddle… I didn’t have pancreatic cancer. Which made me even more angry with the doctor in the country. Since this is Japan though, taking the doctor to task for his negligence and misdiagnosis is nearly impossible. Doctors are treated like gods here.
I look back now and I wonder, though. None of the doctors had specifially checked for diabetes, though I had the beginnings of all the classic symptoms (I still knew next to nothing about diabetes then). Two years later after about three months of suddenly losing half my weight, constant needing to go to the toilet, ravenous hunger and thirst, I visited yet another doctor near my new home in Tokyo and he discovered that my blood sugar was in the 800’s… I could have died any day. I was immediately checked into the hospital with a strict regimen to lower my blood sugar. This was the start of my diabetes.
I’m not sure exactly when the diabetes started, but it must have been around a while, only mild. I remember the exact day and moment, though, when it got bad… and that is weird, too. I was bicycling alone along the coast of Izu Peninsula, south of Tokyo, on a cold winter weekend. On the first night I took lodgings in a small seaside inn, the only guest in the entire place. The owner gave me the best room up on the top floor, a corner suite, with two huge picture windows overlooking the Suruga Bay, with its twinkling fishing boats out along the dark horizon. After taking a bath I returned to my room and sat in the armchair gazing into the night, when suddenly an earthquake hit, setting the whole building atremble. The next moment I got very dizzy and a sharp ringing awoke in my right ear. The ringing has not stopped to this day, and every time my blood sugar goes up, the ringing increases.
The way it all happened makes me wonder about the causes of diabetes. My diabetes doctor today denies that stress has much effect on diabetes, but two years ago, when I returned to the United States to spend five weeks with my brother after 8 years absence from the States and my family, mysteriously, though my eating habits and exercise routine didn’t change much during that period, the blood sugar stabilized at the normal levels of a non-diabetic. Upon my return to Japan, the old blood highs and problems returned, requiring use of insulin daily.
I wonder exactly what mental processes are at work here, what the great stresses of the last seven years have contributed to the demise of my health, and if the proper environment is as much a factor in preventing diabetes as diet and exercise and medicine. I find that my diabetes gets worse in the cold of winter and lightens up during the warmer months of summer. As the causes for all the anger and anxiety that plagued me in the last few years simmer down, so too has the grip of bad blood that coursed through me.
That week when I thought I would die remains with me, especially the first moments along the beach after the diagnosis. It is like a quiet song that plays in the background, arousing me to repeat the chorus. And I keep hearing the sound of the sea, reminding me of where and who I am.
But the biggest question still lingers: the diagnosis failed to confirm pancreatic cancer, but how did the doctor know that there was something wrong with my pancreas?
Coup de Vent ( of London and the North ) wondered about similar quandaries in a post (Changing Landscape) about the frustration and dismay of trying to protect land that is dear. Her thoughts further added impetus to thinking up my own post…