There’s been another mix-up of patient records at a hospital, with tragic results:

A 70-year-old man died in March following a misdiagnosis brought about when his CAT scan results were accidentally switched with those of another patient at a hospital in Numazu, Shizuoka Prefecture, The Yomiuri Shimbun learned Tuesday. Hospital authorities have denied responsibility for the man’s death.

The man, from Numazu, died of a cerebral hemorrhage two days after being taken to the hospital and given the CAT scan following complaints of difficulty swallowing. The results of his scan were accidentally switched with those of another patient who underwent the scan the previous day.

According to hospital officials, the cranial CAT scan was performed on the man immediately after he arrived at the hospital. The technician, however, accidentally gave the wrong scan results to the man’s attending physician, leading to a misdiagnosis that the man had suffered a stroke.

This sort of thing is not at all uncommon–a famous mix-up at a Yokohama hospital led to heart and lung surgeries being performed on the wrong patients–and I wonder whether its roots lie in more than just the way health care, specifically, is run.

Everyone in Japan who works for a decent-sized company has found life somewhat reordered by the new laws, which went into effect this month, governing the handling of personal information. Because Japan is famous for order, carefulness, and semi-conductors, people often make the easy assumption that the handling of information here must be first-rate; but in many ways it’s not. Japanese offices are full of clutter–folders and vertical files and post-it notes piled everywhere are a common sight. True, any office anywhere in the world that hasn’t been prepped for a magazine shoot is going to look worked-in, and because space is at a premium here, separate rooms or closets to keep unattractive piles of paper hidden away are less easy to manage. It’s still true, though, that most Japanese prefer the traditional use of paper documentation and name-stamp approvals to computerized MIS. Most documents go through many hands on their way to being approved or filed, and Japan has had relatively little crime since the war, so it’s not uncommon for documents that contain personal information to be lying about all over the place because there aren’t any policies to prevent it.

Oddly, while information tends to go through many people vertically up and down chains of command, it often isn’t shared horizontally. The in-group consciousness can mean that marketing departments don’t always know what their own R&D people are creating, or how to communicate to them what the customers would like it to do.

Of course, computers aren’t perfect either, and territoriality is not a trait the Japanese invented, as we all know. But so many of the problems you hear about in Japanese health care seem to result not from garden-variety incompetence or questionable judgment but from a specific mishandling of documents: mixing up patients’ charts, not reading warnings about an employee’s conduct, not having received the crucial information in report A. Apparently, the hospitals are run less like the rest of the domestic economy.

So something has come of those plans for Japan to seek help from Israel in upgrading its defense capabilities (via Gaijin Biker). Good. Ever since it was first announced, I’d been hoping more information indicating that plans had materialized would be forthcoming. It’s taken a few months, but I’m glad it’s here. It looks as if equipment, as well as procedure, may be included.

The Connecticut House has passed its civil unions bill. The governor hadn’t threatened a veto, but she had supported an amendment (eventually added) to define marriage as between a man and a woman.

Following the House vote Rell issued a statement saying, “I am pleased that the House of Representatives passed this amendment and made it clear that while we will recognize and support civil unions, marriage in Connecticut is defined as the union of a man and a woman.

“Passage of this bill will extend civil rights to all couples, no matter their gender, and send the unmistakable message that discrimination in any form is unacceptable in Connecticut.”

Good for them.

This Yomiuri article doesn’t seem to know how funny it is–unless the reporter who wrote it has the driest sense of humor in all of Japan. It’s about former employees of private companies who move to government work:

Those who successfully make the leap from the private sector to the public sector are often troubled by a lack of coordination between ministries and agencies in implementing government policies. But they find their new jobs rewarding because of their public nature and the contributions to local communities.

He was appointed section chief before the city had clearly determined what the responsibility of the new section would be. He decided to work on something that had interested him since his student days–involving the public in the creation of a town. He invited younger employees and residents to a meeting to discuss the future of the town. Discussions at the meeting bore fruit and resulted in the improvement of cable television network services and the launch of a local bus service that passengers can use for just 100 yen. [after they pay for the rest of the running cost with their taxes–SRK]

…

Tanaka earns less than he did in the private sector and at times has felt at odds with the local government’s bureaucratic ways. For example, the workload of every section is strictly predetermined and no one wants to take on extra work.

The article isn’t what you’d call a revelation, but it does raise the hope that people with experience working in more results-oriented environment can (slowly) influence things when they move to government work.

You should be reading Eric even when he’s not gallantly quoting me, but the follow-up to his original post on Bill Clinton’s ridiculous comments about campaign strategist Arthur Finkelstein’s opposition to Hillary’s political ascendancy makes a point that deserves to be raised more often:

The fascinating thing about self-loathing is that if we assume that there is such a thing (and obviously there is) why would it be restricted to gay conservatives? Is it not possible that gay leftists might also suffer from self loathing?

And how about heterosexuals? Liberal, conservative, moderate, libertarian… What’s to stop any of these individuals from hating themselves?

You would think that if these jokers (as in, the sorts of gay activists Clinton is likely to have picked up the wording from) were serious about combating self-loathing among gays, they’d devote their energy to outreach programs for gay youths who are terrified out of their minds at what they’ve just discovered about themselves. Or for drug and sex addicts, whose behavior is flat-out self-destructive. It seems to me that the last place a reasonable person would go looking for self-loathing is among centered, ordinary people going un-hysterically about their daily lives; but, then, for some people, the opportunity to take potshots at political opponents is a good that trumps all others.

Okay, I know that complaining about Salon‘s culture criticism is pointless, so this is kind of like shooting fish in a barrel. Dead fish. But still, there’s something unusually dunderheaded about this whine about how Gwen Stefani and others don’t understand the Asian iconography they’re appropriating:

They shadow her wherever she goes. They’re on the cover of the album, they appear behind her on the red carpet, she even dedicates a track, “Harajuku Girls,” to them. In interviews, they silently vogue in the background like living props; she, meanwhile, likes to pretend that they’re not real but only a figment of her imagination. They’re ever present in her videos and performances — swabbing the deck aboard the pirate ship, squatting gangsta style in a high school gym while pumping their butts up and down, simpering behind fluttering hands or bowing to Stefani. That’s right, bowing. Not even from the waist, but on the ground in a “we’re not worthy, we’re not worthy” pose. She’s taken Tokyo hipsters, sucked them dry of all their street cred, and turned them into China dolls. [Am I the only one who wants to blow groceries when people use words like hipsters and street cred with no irony?–SRK]

…

Stefani fawns over harajuku style in her lyrics, but her appropriation of this subculture makes about as much sense as the Gap selling Anarchy T-shirts; she’s swallowed a subversive youth culture in Japan and barfed up another image of submissive giggling Asian women. While aping a style that’s suppose to be about individuality and personal expression, Stefani ends up being the only one who stands out.

Sweetie? How ’bout you try this? Go to Harajuku. Watch the way Harajuku girls actually behave. You will see them acting just as giggly, catty, and coy around cute boys as teenaged girls anywhere else. They use the same helium voices as other good Japanese girls, too. In fact, you can think of it this way. Which of the following do you think Harajuku girls more aspire to be like?

1. Gwen Stefani, who has millions of fans, makes millions of dollars, is fawned over by stylists and journalists, designs her own line of clothes, and used to screw Gavin Rossdale

2. A leftish SF journalist who sulks that Asians aren’t being presented soulfully enough in pop culture and seems not to have been sassy enough to put a bigot in his place when he condescended to her

Remember, Japan is a culture that really, seriously values surfaces. That’s not to say that Harajuku girls’ sense of style isn’t fun and invigorating, but I think it’s safe to say that it’s mostly a fashion thing and really isn’t about the sort of full-on punkish rebellion that it might be among teenagers in the West. (The really disaffected Japanese kids are either locking themselves in their rooms or attacking classmates with knives.) And there’s just as much insider conformity visible among Harajuku girls as there is in any other Japanese group; that some of them have rejected the larger exam-hell scheme their parents might like them to stick with doesn’t change that.

Personally, I find Stefani’s new music and videos annoying. I think her use of her entourage is a rather witty way of making the same oddly-humble point Madonna made 15 years ago in the “Vogue” video, though: a star is a star because she’s surrounded by people whom she depends on, utterly, to help make her one. Of course Stefani ends up being the only one who stands out. Pop music thrives on groups of anonymous backing singers and dancers whose sole duty is to magnify the charisma of the headliner. I’m sure her four back-ups are at least being paid pretty well for the job they do, and it probably beats temping or meat packing.

Making them speak only Japanese is a bit on the cute side (it’s not geisha-like, either, since geiko were trained in multiple art forms and expected to make intelligent conversation on whatever topics their clients raised). Then again, I can see how the effect might be ruined if Love and Angel were seen slouching around and saying things like, “Oh, wow. That guy over there? With the press pass and the hair in his eyes? I think I know him? Uh, from sophomore year at Oberlin? Before I became, you know, a performance artist?”

Japan is set to begin the process of exploratory drilling in the contested East China Sea natural gas fields. Sort of:

The government officially resolved on 13 April immediately to begin proceedings to grant permits to private enterprises for exploratory drilling to open the natural gas fields in the East China Sea that have become an issue in Japan-China relations. The government’s assessment is that, since China has proceeded with its own opening of gas fields close to the China-Japan boundary line (midline), Japan is in danger of losing access to critical natural resources if it delays the process any further. Resistance is expected from China, and the government is carefully weighing whether drilling should actually be permitted to go ahead [presumably even if permits are formally issued].

Minister of Foreign Affairs Nobutaka Machimura is to travel to Beijing for a meeting with Chinese officials and plans to raise the issue there.

He has also been quoted, for what it’s worth, on the textbook issue:

If our Chinese counterparts agree, an effective way to go would be to establish a place for joint Japan-PRC historical research.

Japan and the ROK already have such a joint program. It doesn’t seem to have had much effect on Japanese textbooks, political speeches, or pilgrimages to shrines, unless I’m missing something.

Added perilously close to the end of lunch: Okay, just one more thing. Here’s CNN’s latest article on the contretemps, including this quotation from PRC Premier Wen Jiabao:

In the latest flare-up between the two former rivals, Chinese Premier Wen Jiabao told reporters in New Delhi on Tuesday that Japan must “face up to history squarely” and that the protests should give Tokyo reason to rethink its bid for a permanent council seat.

“The strong responses from the Asian people should make the Japanese government have deep and profound reflections,” Reuters news agency quoted him as saying.

“Only a country that respects history, takes responsibility for past history and wins over the trust of the people in Asia and the world at large can take greater responsibility in the international community,” he added.

That’s fine, but I’m not entirely sure China wants to be raising doubts about who’s qualified for permanent membership on the UNSC, since the obvious flip-side question is, what does China do to justify its existing membership except sit there and, you know, be huge? You may not always like what the US, UK, France, and Russia do with their global influence, but you can’t deny that they’re involved in world affairs. China has a booming economy and sends a lot of people abroad, but you don’t see it playing a key role in incidents of major international dispute or cooperation. I’m not, obviously, suggesting that it would be a good idea to kick the PRC off the UN Security Council, but respect for history and respect from the neighbors are hardly the only criteria worth considering here.

Speaking of enjoying the city, I think I’ll take the new Garbage album and listen to it for the first time while walking up Meiji Avenue, with the machines being used to build the redundant new subway line hulking alongside. and a lot of very large, garish billboards on strategic corners. Shirley in her natural habitat.

Via eve ry one, comes this website. My trust-no one instincts say it could be a well-intentioned fake (the guy is utterly adorable–Japan is like a chest-hair deprivation tank, lemme tell you–but it seems odd that he would use those pictures as part of a testament of how tradition-minded he is…not that I mind). Assuming it’s genuine, the guy has balls. It’s the easiest thing in the world for guys like me to be out at home; I fled my little hometown for college so fast there were skidmarks on Main Street, and since then, I’ve lived in Philadelphia, New York, and Tokyo–I go back to Emmaus because that’s where my family and a friend or two are. If they weren’t, I’d be perfectly happy to forget the place existed, though I don’t look down on others for choosing to stay or make their home there. Good on Daniel for not backing down and for being able to write with feeling without getting drippy. I’m moved.

You gotta love that Dean. He takes that book quiz that’s floating around and decides that one of the people he’s going to pass it on to is “Sean Kinsell because he’s fun to pick on.” (Word to youngsters in the audience: You know how your parents keep telling you that when you grow up, you’ll find like-minded people to hang around who will love and respect you for you you are? It’s a total crock. Trust me–the best policy is swift and unapologetic VENGEANCE.)

I wasn’t going to do anything with this, but today happens to be exactly one year after my first post. I never really planned to start a blog; I liked commenting at other people’s places. But when Atsushi was transferred last March and I wanted something to help fill time while I felt sorry for myself, I asked Dean to set this up for me. As in, I got out my credit card and signed up for MT and hosting, and Dean presented me a week later with a blog ready for writing to (of course, I immediately set about changing the fonts and faggifying the color scheme, but I could have gone with his original template and had a respectable blue-and-white theme…sort of like on-line ticking). He’s also helped me out a lot with my dumb-ass tech problems and by linking to me frequently.

And, as you can tell, I’ve warmed to it. The number of readers I get amazes me; I’m very grateful. And it’s been good, I think, for my relationship with Atsushi. His English is great, but we speak Japanese at home and watch Japanese television and have all Japanese friends. There’s nothing about that that’s a problem–it’s the life I’ve chosen–but it means that he rarely gets to see me be a full-bore American in my native tongue. With the blog, he does, and, while I know I don’t always show myself to best advantage here, I think it’s a good thing that he has a fuller idea what kind of man he’s with.

Uh, so anyway, thanks again to Dean and to all of you. For more about the Real Me, here’s that book quiz:

You’re stuck inside Fahrenheit 451, which book do you want to be?

Don’t we all die, anyway? If I could be any book until either the firemen or the bomb got me, sheer arrogance would make me want to be the Bible (the KJV–none of that bowdlerized “accessible” crap), which is probably more important in Western history than any other single book.

Have you ever had a crush on a fictional character?

I really don’t think so.

The last book you bought is:

Singular? Like one at a time? This test was obviously not written by a book addict. Uh, say 破戒 (hakai: “broken commandment”) by Shimazaki Toson. That wasn’t actually it, I’m pretty sure, but it’s kind of first in line for me to read next.

The last book you read is:

To be brutally honest? There was a copy of The Rules lying around our office–heaven only knows why–and I drifted through it while waiting for a friend.

What are you currently reading?

The book I’m carrying around with me and officially trying to get through is The Golden Bowl by Henry James; this time I’m going to finish it.

Five books you would take to a desert island.

• 恍惚の人、有吉佐和子作 (kokotsu no hito, ariyoshi sawako saku: “The Ecstatic Ones by Sawako Ariyoshi,” translated pretty effectively as The Twilight Years )

• A History of Civilizations by Fernand Braudel
• The Complete Poems of Emily Dickinson
• 新古今和歌集 (shinkokinwakashu), the third of the anthologies of Heian Court poetry
• Miss Pym Disposes by Josephine Tey

Who are you going to pass this stick to (3 persons) and why?

I beg your pardon! I don’t discuss my stick with anyone but my boyfriend.