My wife is not very good at saying ‘shit’ in English. This is because it is a swearword and she is aware that only the very most accomplished speakers of a foreign language can swear with aplomb. I can sense her awkwardness when circumstances require that she use it, even when the word is employed in a non-sweary way. The reticence is there in the way she lowers her voice and winces slightly when she utters the word. But every year, at least once, utter it she must. She hands me a small, clear, zip-lock bag containing two small brushes sealed in vials of liquid, and says, ‘The health checks are coming. You need to put some,’ and here she cringes and does a sort of hand-mime of a fart leaving an arse, ‘shit on these brushes.’
‘Right,’ I say. ‘Stick the bag in the toilet.’ And I wonder what non-international couples say. Do spouses say ‘stool sample’ to each other? A bit formal, surely. ‘Poo’? Too cutesy. ‘Turd’? Feels somewhat hostile. No, ‘shit’ is the best word in the circumstances. I must put some shit on two small brushes and, a couple of weeks later, take them across to the community hall. When I hand them over, I do so silently because I am always forgetting to learn how to say ‘stool sample’ in Japanese, and I fear that the word I know for ‘sample’ is only applicable to stuff you taste in supermarkets. And that could be an awkward mistake. So silence it has to be, as beginning a conversation with, ‘Good morning,’ before lowering one’s voice and saying, ‘I’ve brought you a jobby,’ just seems wrong.
The Japanese are well-known for their longevity. They are consistently at the top of the long-life charts, with the most recent figures showing an overall average life-expectancy of 82.6 years. Sometimes this is hard to fathom. Alcohol appears to be consumed in vast quantities and when you walk around certain entertainment districts of large cities at night you encounter scores of drunk salarymen, shambolically shuffling to the next bar, the last train, or a capsule in which to bed down for the night. Cigarettes are cheap and popular. Men cough in a manner suggesting they are trying to expel their liver through their mouth. People die from working too hard. Suicide is regularly in the news. And yet, in spite of all this, enough people live longer than 82.6 years to make that an average. How so?
Well, much is made of the diet, of course. A history of eating less meat and more fish, plenty of green tea, smaller portions than most western countries, the Okinawan practice of hara hachibu – eating until you are just 80% full – may all play a role. But then there is the salt – in the pickles, the soy sauce, the miso – which it is widely believed contributes to Japan’s other diet-related chart-topping statistic: that of gastric stomach cancer rates. The long lives are probably not just down to diet. They can’t be down to lack of stress or a relaxed lifestyle. There is probably something in genetics, and, who knows, there might even be something in the theory of a friend of mine who is convinced that one day we will look back and realize that it was because of time spent in water and the practice of nightly bathing. As important as all that, however, and perhaps more so, is the fact that they have excellent habits regarding early detection of illnesses.
Almost every company in Japan requires its employees to undergo annual health checks. X-rays, barium drinks and blood tests are all used to spot any little blemishes and weirdnesses that we should be concerned about. You get a report at the end giving you As and Bs, Cs and Ds for various organs and functions of your body and generally telling you how well or unwell you are. It’s not fun, of course, but it is good. Things that we would ignore or otherwise not even notice get discovered. My father-in-law’s stomach cancer was found in such a check and thankfully it was early enough that removal of the tumors was possible and a normal life resumed. My father-in-law is not a man who complains. He is also a man who would likely not tell anybody if he was having stomach pains unless they were unbearable. He would surely have done his bit in lowering the life-expectancy average were he not told to have an annual health check by his company.
Even if nothing major is wrong, I have discovered through experience that a doctor will have no hesitation in telling you in a rather disconcertingly frank manner that you are fat. When you know you will have to see that doctor again the next year it makes you think about trying to shed a few pounds before he gets the chance to call you fatty again. Likewise, when the report card says of your kidney, ‘Must try harder,’ you take notice.
Now, I don’t work for a company so nobody compels me to take such health checks, but here is the other rather wonderful thing about this particular pocket of Japan: each year a travelling hospital of sorts comes to town. The community centre, which happens to be just up the road from my house, puts up a few screens and curtains, some doctors and nurses roll up, and everybody deemed to be of middle-age or above can pay 1,000 yen and get a fairly thorough physical. It’s not completely comprehensive, of course, but I’ll take it.
When you have gathered your stool samples, you must write the date and time of each sample on the tube. On the way to the community centre I noticed that both of mine were taken at 9:37 am.
‘Have you got a pen?’ I asked my wife.
‘No. What do you need a pen for?’
I explained I needed to change the time on one of my samples. My wife frowned wondering what she hadn’t understood.
‘They’re the same time,’ I said. ‘Exactly the same time. They’re going to think I’m an obsessive compulsive shitter.’
I blushed as I handed over my samples and was then given some forms to fill in before being sent for the other tests.
I was measured and weighed in full view of several of my neighbours and then handed a paper cup and told to pop off to the loo to take a urine sample. I stood next to an elderly chap, both of us trying to pretend it was normal to piss into a cup at a urinal. We walked out and handed our samples to the nurse who placed them on a table and put a strip of paper of some sort into them.
My wife caught up with me in the main hall.
‘Your pee’s fine,’ she said.
‘How do you know?’ I asked.
‘I saw what they’d written.’
The blood pressure checks and taking of blood samples were equally unprivate, but our heart-monitoring and chest-listening were at least done behind a screen. My neighbours were lined up on the other side of the screen awaiting their turns, though, and conversations between doctor and patient could easily be heard. With the barium drink and x-ray I had to remove my jeans behind a small curtain in a van, accompanied by a gruff farmer who, dressed in his underpants and a vest, told me he often sees me walking around the neighbourhood.
I came home complaining to my wife about the lack of basic privacy. She listened with good grace, as is her way, refusing to get drawn into an argument about cultural differences. But without this travelling health consultancy I would likely never bother getting checked out at all. I suppose I should be grateful. A thousand yen and allowing strangers and neighbours a look at a foreigner’s urine is a small price to pay for something which might just save my life.