“It is a common practice over there to offer each other a cigarette as daily greetings.”
“So I heard. Cigarettes are offered to the other to express friendliness and affection.”

I stood in front of the machine and read the sign again, just to be sure. Outside the dimly lit lobby, another cold, gray morning in Fukui, Japan was underway. The sky coughed with thunder, sending sleet and rain skittering down upon the pavement in freezing waves. Was I even in the right place? I wasn’t sure. It seemed like it could be the right place, if maybe a little grimier than I’d expected. And there was also the issue of the vending machine.

“It is a common practice over there to offer each other a cigarette as daily greetings.”

Packs of cigarettes receded in orderly rows behind the plexiglass facade. The words were in English. But the cigarettes, the vending machine, and the building we all occupied were unarguably Japanese. The existence of a vending machine that sold cigarettes was not surprising by itself; if anything, it was a visible reminder that I was still in Japan, where anything and everything from cellphone cases to contact lenses to lightly worn women’s underwear is sold in a vending machine somewhere. Of cigarette vending machines I’d already seen thousands in this country, so I was unimpressed by the one in front of me. It was the sign on it that had captured my attention.

Over there where?

Maybe this was some Japanese vending machine marketing guy’s idea of a clever way to sell cigarettes to Americans. If so, I thought, it wasn’t really very clever, was it? Americans by and large being from America, we’d know it if a part of our daily greeting involved being affectionately offered a cigarette by everyone we ran into. Conversely, maybe it was an American marketing guy’s idea of a clever way to sell cigarettes to Japanese people. If so, I thought, not only was it not clever, it was positively pathetic. The number of Japanese people who could read this exchange in English was microscopic to begin with. Subtract from those the number dim-witted enough to believe it, to the point where they’d actually be motivated to buy a pack of cigarettes and offer one to someone in a gesture of goodwill, and you probably couldn’t fill a small elevator.

I read the sign once again. The English wasn’t bad. Actually, it was not bad enough, I began to think, to have been written by a Japanese marketing guy, whose command of written English, in my experience, is rarely above disastrous. Though, to make up for it, the result is almost always entertaining. This was neither disastrous nor particularly entertaining, though I was willing to give marks for audacious and bewildering.

Standing there, scratching my head over an imagined conversation between two fictional foreign smokers of cigarettes living in an anonymous marketing salaryman’s head, I realized I was letting myself be distracted from the more germane point at hand, which was that no person should have to grapple with the near-term prospects of his own mortality in a hospital which has a cigarette vending machine in its lobby.

This would seem obvious. Yet on the other hand, here I was, standing in a hospital lobby, or what I thought to be a hospital lobby, about to walk upstairs to see a Japanese physician and in all likelihood learn that I had a life-threatening illness, while one floor below me there stood a cigarette vending machine with a sign on it encouraging people to inhale carcinogens together in the name of fellowship.

Obviously, I was stalling. Not even in the subconscious sense but in the full awareness that I was doing so, I lingered in the moldy lobby while a mixture of ice and rain spattered down outside. Fukui has been described to me on several occasions as “the Kansas of Japan.” I’ve also heard it likened to certain unflattering regions of human anatomy. Whenever I mention to someone in another part of the country that it’s where I’m living while I’m in Japan, I always seem to get a subtly cocked eyebrow in response, as if I’d told a Canadian I’m using Iqualuit as a home base while visiting his homeland. I was beginning to realize, however, that what Fukui lacks in metropolitan flair it more than makes up for in rain. It had rained virtually every day for the past three weeks. When I ask locals if it always rains this much in Fukui during winter, I’m usually told, “Yes, but in January it turns to snow,” which I think is meant to be comforting.


Please let it not be too deadly an affliction, I thought as I worked up the courage to go upstairs and begin waiting. I’d spent some time preparing myself for a variety of outcomes to my visit, and I thought I might be capable of receiving with a measure of dignity and grace all but a few of the worst possible diagnoses that could be handed down that morning. On the other hand, who knew? I might collapse into a wailing fit of hysterics and soil myself when the verdict was read, there’s no way to tell until the moment’s upon you.

A week previously, I’d begun to experience a slight soreness in the muscles around my left shoulder blade and within my armpit, and the skin of my shoulder and upper arm had become sensitive and painful, as if suffering from razor burn. At the same time I’d begun to notice when I was very still a regular pattern of short, sharp, small bursts of pain inside my chest, high and slightly to the left, roughly in a region that I imagined to be filled with critically important blood-delivery systems like aortas and ventricles and arteries. In fact, it had occurred to me that there are almost no unuseful organs located in the upper left chest region, as opposed to an area like the lower intestines, which seems to be a bit of a junkyard for old and antiquated bits of biology, a region in which short bursts of discomfort are a regular occurrence, hardly cause for alarm or any action more decisive than reaching for a laxative.

Also, I’d always been healthy as a horse, preternaturally lucky when it came to my physical well-being. I’d never broken a bone in my life, not even as a death-courting, high-school-football-playing adolescent. I’d never been on any medication stronger than antibiotics, never even had my wisdom teeth out. Once, when I was in college, I was diagnosed with mononucleosis at the university health clinic. Yet afterward I showed no signs at all of fever, sore throat, muscle soreness or fatigue (though none of this worked to my benefit with my girlfriend at the time). I could count the number of days I’d lost to flu in my life on two hands, with fingers to spare. All my grandparents had lived at least into their eighties, two of them into their nineties. I’d waltzed through my entire medical history with the carelessness and confidence of someone who knows he’s charmed.

But the mind of a man who has recently rounded 40 is different from the mind of a man in his 20s or 30s. And the mind of an uninsured man who is past 40, one who hasn’t had a regular physical exam probably since a Democrat was in the White House, is infinitely more different still. So it was understandable that a pattern of even small short pains in my upper left chest region would command my full and undivided attention.

The first person I’d called was my father in South Carolina. He’s now retired, but my father spent his professional life as an immunologist, a field I never really understood fully, but which I’d always thought of as a fancy sort of microbiology. My father is technically a doctor, but, technically, so are lots of history professors. Having a Ph.D. is obviously not the same as having an M.D. This has never stopped him, however, from dispensing medical advice to me, my sisters, or anyone else within earshot at every possible opportunity. I think he always justified it on the grounds that he spent a lot of time around doctors, and so he felt comfortable with the language, which either made him very useful, or very dangerous, I’ve never been able to decide.

What immunologists do know a lot about is infectious diseases, and as kids my sisters and I learned quickly not to ask any questions of him that had anything to do, however tangentially, with infection or disease or illness of any sort, unless we were prepared for a lecture-length description of the bug in question, its complete pathology, and the vivid physical effects of its tenure in the unlucky slobs who encountered it. This was especially true at dinnertime, when he knew he had a captive audience. My father felt no compunction at all about illustrating the ravages of an exotic disease in gory, technicolor detail at the dinner table. These disquisitions were hard on my sisters and me, but for my mother they were a kind of special torture, to which she’d developed a complex but almost entirely nonverbal language of protest. She would begin by blanching and rolling her eyes, then progress into a series of increasingly loud sighs. When this failed to stop him, as indeed it always did, she would begin letting her fork hit the plate more and more loudly as she continued stoically to eat, setting up a staccato symphony at her end of the table, which increased in volume as she decreased in color. My father always either ignored these theatrics or – and this is entirely possible – he was oblivious of them. My father, it should be noted, is not the most discerning person in the world. Regardless, he never let up until my mother, eyes rolling madly, hyperventilating and grey with disgust, would drop her fork on the plate with a clang and close her eyes. “Bob!” she’d groan. My mother was not the most communicative person in the world.

“What?” He was always innocent as a lamb.

“Can you please? Not do that at the dinner table?”

“What, they’re interested.”

No we weren’t, not really, but he never noticed that either.

Still my father’s the closest thing to a doctor I have in my family, and also I needed to talk to someone close to me, preferably someone who would tell me not to worry, that it was probably nothing. This, my father happens to be very good at. He might actually be better at denying the incidence of disease in his own family than he was at pinpointing actual outbreaks of disease and their transmission as a professional immunologist in the real world. For a guy who dealt with contagion and blight all his career, my father has always been paradoxically skeptical about their occurrence near him. He would have made a terrible physician, as his bedside manner consists almost entirely of assuring people that there isn’t anything wrong with them. The fact that he’s nearly always right has done nothing to lessen me and my sisters’ certainty in each new instance that, this time, he’s probably wrong.

“It sounds like you’re having a panic attack,” he’d said on the phone.

“That’s ridiculous,” I’d scoffed. “I’ve never had a panic attack in my life. My shoulder hurts, the skin on my arm is painfully sensitive, and there are strange, rhythmic flashes of pain in my chest. How can you possibly think I’m having a panic attack?”

“Your mother had panic attacks. Are you feeling anxious about anything?”

“Yes! I’m feeling anxious about the fact that I’m having bursts of pain in my chest! It’s not a panic attack!”

There’s something of a history of panic attacks in my family – my mother had them for the last 15 years of her life with the regularity and dependability of astronomical events – so for some reason it always seems to be the first diagnosis that pops out of my father’s mouth, once he’s insisted that it’s probably nothing and you’ve insisted right back that, on the contrary, it’s definitely something. “It’s probably a panic attack.” I even know the medical name for this condition: agoraphobia. It’s a disorder whose sufferers experience intense random, irrational attacks of mental and physiological anxiety.

To the best of my knowledge, agoraphobia is not an infectious disease, but my father seems determined to make it one. All my life, I’ve deflated his efforts by stubbornly refusing to have a panic attack. Nobody who knows me would ever describe me as a Pollyanna, exactly, but I’ve always been a pretty even-keeled kind of guy, immune to the epic mood swings that periodically flattened my sister and my mother. My swings are more likely to be brief fits of rage at inanimate objects on which I’ve banged my head or upon which I’m venting my wrath over having lost something small but significant, like a set of keys or a wallet, which happens to me with alarming frequency. To a casual observer, these fits might look like the ravings of a man with any number of disorders, and so they may be. I’m just as fucked up as the next guy. But agoraphobia is not among my problems.

“Well, just remember the snorkeling thing,” he’d said.

Of course he would bring that up. I should have known he wouldn’t be able to resist. About three weeks after my arrival in Japan, I’d had a brief scare when I cleared my throat one day and spat, as a guy is wont to do first thing in the morning, and there’d been blood in it. Not just a few little flecks of blood, either; it was dark with an inky crimson all throughout. I’d called him in a spasm of terror, which I still feel was justified. After all, nobody wants to contract hemorrhagic fever on their third week in Japan. He’d listened, then quietly reminded me that, hadn’t I gone snorkeling a couple of days earlier? Yes, I had. Hadn’t I told him that a few times when I’d dived the pressure had been so great it’d given me a nosebleed? Well, yes I had, I’d said, trying for some inexplicable reason to hold on to hemorrhagic fever. Tell me if it’s still bloody tomorrow, he’d said. The blood had disappeared the following day.

Now, I could see he was going to wield this victory like a sword over me the rest of my life. It was almost enough to make me wish I’d contracted hemorrhagic fever, just to prove him wrong once.

“This is not like that,” I’d said.

“Okay, if you say so.”


The next phone call was to my friend Ken, an American co-worker at the private Japanese school where I tutor English. Ken, I knew, had firsthand experience with Japanese healthcare. A half dozen years earlier, he’d visited Japan with his wife, Miwako, whose father is the head of surgery at Akara Hospital in Fukui. During a routine physical exam while visiting, Ken, who’d never smoked and was only 34 at the time, had learned to his surprise that he had lung cancer. He’d eventually beaten it, but it had come out of nowhere, and it was partly responsible for his remaining in Japan ever since. Ken speaks English, which was also a big point in his favor, and he, like me, had been, as our kind refer to ourselves, “between insurers” at the time.

Yet the very last thing I wanted to think about was cancer. My mother died in 1997 after a two-year struggle with ovarian cancer. Since then, the thought of cancer has had an irrational effect on me, the sort of effect that the thought of, say, being buried alive probably has on other people. So I decided to call Ken but limit the conversation to questions about insurance concerns and the like, without going into the details of my condition.

“I don’t want to scare you,” he’d said, “but that sounds exactly like lung cancer.”

In the entire English language, there are probably only a few combinations of words which would have a greater effect on me than those six. “The Sun is about to explode” and “I’m your thirteen-year-old daughter” might be among them, as would “you have the winning Powerball ticket.” But “that sounds exactly like lung cancer,” coming out of the mouth of a person who’d recently had lung cancer, is the sort of phrase that, once you hear it, lodges itself in your brain in a way that assures that whenever there’s something to be thought about, it’s at the very front of the line. It’s the sort of phrase that makes all other concerns, which until a few moments earlier had seem quite pressing, suddenly vanish into near-invisible blips in a wall of static, before which stands this Huge New Thought.

Suddenly it seemed so obvious. Of course it was cancer. How could I not have realized this before? The more I focused all of my senses on that region of my chest, the more clear the outlines of the sickness inside it became. It felt just as I imagined a soon-to-metastasize tumor on the left lung must feel. The discomfort around my shoulder was now easily explainable: the cancer was gnawing away at a bundle of nerves that passed by it on their way to my arm; it was just a secondary effect. It felt like I was carrying around a mass the size and heft of a billiard ball above and to the left of my heart. I could feel the pressure it created on the tissue around it as it sat there, a malicious black mass intent on my destruction, the last inanimate object I’d ever struggle against, silently avenging the damage I’d done to its brethren everywhere over the years, not to be satisfied until I was one myself. Except that it was animate, wasn’t it? It was a living thing in there, a collection of furiously multiplying cells, eating me from the inside out. It wasn’t a pleasant feeling.

This was it, then. I was going to die in Japan, thousands of miles away from my family and friends. It was almost as not good a thing as ungood things can be. I tried to look for positive sides. There weren’t many. The bloodsuckers at the credit card companies would just transfer any unpaid debt to my family, the fiends. My cat would probably outlive me back home, so at least I wouldn’t have to suffer through that. Hadn’t I signed up for a some sort of life insurance program with AAA that came in the mail about four years ago? That might just cover the funeral fees, if I was lucky. Did anyone anywhere owe me money I had forgotten about? This seemed a good opportunity to collect. It’s hard to be a cheapskate on someone who’s dying.

I tried to think about the coming ordeal with equanimity. There was a chance, however remote, that I might beat it, as Ken had. The disease felt advanced, but c’mon, did I really know what an advanced cancer felt like? I did not. I wasn’t coughing. I had no difficulty taking a deep breath. I wasn’t listless and tired. In fact, having lost 35 pounds since my arrival in Japan four months previous, I felt as healthy as I ever had, apart from the invisible, festering malignancy behind my ribs. Maybe it wasn’t as far along as I feared. Fighting it was going to be difficult, probably the most difficult thing I’d ever experienced, but didn’t people who recovered from terrible diseases often find themselves utterly changed, for the better? Maybe I’d somehow emerge victorious, a completely new person, focused, fit, and ready to enter the most productive creative phase of my life.

This what I tried to focus on as I stood in the hospital lobby, watching the rain fall and the sleet shiver down the sidewalk outside. Ken’s wife, Miwako, had hastily arranged an appointment for me with a physician friend of her father’s at the hospital, an internist. A morning full of x-rays, EKGs, bloodwork, and probably a lot of poking lay in front of me, all of it doubtless accompanied by a great deal of incomprehensible Japanese. I was early, but this was a hospital. Nothing happens on time in places like this. I sighed and started toward the stairs, dreading the wait almost as much as the inevitable result.

My cellphone rang. It was Kaori Umeda, one of the young Japanese girls who works as an administrator at the school where I tutor English a few days each week. She’d offered to meet me at the hospital and translate. I flipped open the phone. “Mushi mushi,” I answered in the standard Japanese greeting.

“Mushi mushi. Where are you?”

“I’m here,” I said.


“In the lobby, next to a cigarette machine.”

“What cigarette machine?”

“The one in the lobby.”

“Which lobby?”

“The one in the hospital. Where are you?”

“What color is the building?

I walked outside and peeked out from under my umbrella, peering up at the building. “It’s brownish gray,” I said into the phone. “It’s right across from a pink building.”

“You’re in the wrong place,” she said. “That’s the administrative offices. Go to the pink one.”

I trudged across the street, feeling like a fool, and went upstairs to the actual hospital lobby, which was mercifully free of cigarette machines. Waiting there I found Kaori, Ken’s wife Miwako, their three-year-old son, Hiro, and another of the American Club’s teacher/admins, Nagisa. They all wore expressions that matched my own expectations for the morning’s visit; clearly they knew they were looking at a dead man. I could see it in their eyes, even in those of the three-year-old, who was careening off every unmovable object in the room: a mixture of pity, worry, and infinite regret. Not only was I doomed, their faces told me, but I was uninsured as well. It doesn’t get much worse than that.

It was actually something of a shock to find not one but three people – and if you count the kid, four – there at the hospital for me. My real family was 7,000 miles away, but here this group of people I hardly knew had taken precious time out of their own mornings to sit in one of the most depressing places in the world and provide moral and linguistic support to a foreigner in their country who spoke less then 50 words altogether of their language. I was touched deeply, and as each of them approached me to ask in a soft voice how I was feeling, I tried to convey my gratitude.

This I did in as subtle a fashion as possible. One thing about the Japanese, especially in rural places like Fukui, is that they don’t go in for big displays of emotion. In fact, it’s about the most embarrassing thing most of them can imagine. In America, we like our emotions served up by the gallon, supersized and over-the-top – in airports, at ballgames, on television, at the mall, in traffic, around the dining room table. In this respect, we’re like Italians, who never met an emotion they couldn’t wring tears from, preferably in a crowded room with lots of cameras around. But Japanese people are far more reserved. Public displays of any kind are anathema to them – the smaller the town, the more so. You can find emotional exhibitionists all over the place in the huge, westernized metropolises like Tokyo, Osaka, Nagoya, and Sapporo. But most natives would prefer being roasted and disemboweled to being subjected to a hug in a public place, and being involved in an audible argument would be incentive for any Japanese person to commit seppuku on the spot, even if the sharpest instrument at hand was a melon scooper.

This can actually be used to your advantage, if you’re a foreigner. If, for example, things are not going your way in negotiations with a street vendor, just raise your voice, begin gesticulating, and start to make a stink. You’ll be walking away with an affordable souvenir before you can say “Arigato goziemas.”

I was taken aback at the concern in these women’s faces. Did I really look that bad? What exactly had Ken told them? It’s not like I was being pulled out of an ambulance on a stretcher, after all; I was still upright, moving under my own volition. But they were looking at me as if I were carrying my own head under my arm.

This concerned me especially because Nagisa was there, which I hadn’t expected. Before I’d come to Japan, I’d worried out loud to several friends that I might not find Japanese girls attractive. Nagisa, who’d I’d met at the Club almost immediately on my arrival in Fukui, put to rest any doubts I may have had on that count. I’d asked her out several times, always in a casual, just-us-two-co-workers-hanging-out-as-friends sort of way, always unsuccessfully. She had a boyfriend of something like five years, but she rarely saw him because he was busy with some restaurant scheme, and he seemed oblivious of what an attractive girl he was ignoring. She never shot me down completely, though; each time, the excuse was just plausible enough and delivered with convincing enough a facsimile of regret to keep the torch I carried for her barely alight. I’d been unsure of how best to appeal to a Japanese woman, so in the four months we’d been working together I vacillated between charming and aloof, with some goofy thrown in for good measure. This seemed to have left her with the impression that I was either feebleminded or had some sort of rare psychological disorder. The fact that I was 15 years her senior probably didn’t help any either.

So in addition to being in a long-term relationship and believing me retarded, Nagisa was now a witness to my physical infirmity. My chances of getting a date were heading for the toilet on a rocket.

“How are you?” she leaned over and whispered to me, once I’d greeted everyone and checked in with the nurse behind the desk.

“I’m fine, really, I feel fine,” I smiled. “It’s probably nothing.”

She squeezed my arm and looked at me with an expression that said, “You poor, pathetic, ailing, delusional old man, your mortality is at hand and still you’re trying to get in my pants.”

We all stood around, except for Hiro, who continued to bounce across the lobby, arms and legs spinning with the power of independent turbines, looking like the haywire result of a scientific experiment on perpetual motion. He alone seemed oblivious to the solemn mood in the room. His mother kept one eye on him but otherwise gave him the run of the place, the people and furniture in it, and any passing hospital employees. I kept an eye on him, too. I find you have to be particularly careful of kids like that, because they’re at the exact height to be most dangerous to an unobservant adult male. You take your eyes off them for an instant and you’re likely to find yourself writhing in pain on the floor, clutching your groin, while the little perp hurtles merrily away toward his next unsuspecting victim.

So I watched him carefully, and I waited for his mother to restrain him, but this didn’t happen for two reasons. The first reason is because Japanese children are spoiled rotten. They’re treated with extraordinary indulgence, the kind you don’t see even in America except among the pampered heirs of hotel empires. This is mostly because once boys here are old enough to enter university, they spend the rest of their lives as salarymen – suit-clad slaves eking out a living by working 70 hours a week plus holidays because that’s how it’s done. If they’re girls, it’s much the same, unless they get married and become housewives, in which case it’s still much the same. Parents, knowing what’s in store for their children and ever mindful of their own lost youths, seem to have difficulty raising them with anything but the most gentle sort of magnanimity. As a result, kids get away with murder here. If, when I was four, my mother had told me to do something and I replied in the negative, as I’ve often seen Japanese kids do, I would have been slapped into next week. “No” was not a word a child used in my mother’s presence unless he was clad in full body armor.

The second reason Hiro’s mother did nothing to restrain him, of course, is because Hiro’s grandfather is the head of surgery at Anaka Hospital.

The wait was surprisingly short, but when the nurse came for us, I was ready. We went straight to the examination room. There I was left alone with the nurse, who was very cute in the manner of certain Japanese girls who look like they’re just a fraction of nothing away from being cross-eyed without actually being cross-eyed. Since I’ve been in Japan, I’ve come to find this feature irresistible in a pretty girl. In fact, I thought this one looked rather like the actress Lucy Liu, who uses this look to splendid effect in lots of movies which, without the benefit of her almost-crossed eyes, would be unwatchable.

As I was admiring her, Lucy Liu spoke to me in rapid-fire Japanese. Without my retinue of translators I was helpless, so I smiled back and said “Wakarimasen, gomen nasai” – “I don’t understand, so sorry.” She pantomimed to me that I should take off my shirt. I considered briefly pantomiming back that I would if she would, as suddenly I was feeling flirtatious, and also I thought not many people would be able to say they’d looked Death in the eye and hit on his handmaiden. Besides, she might even go for it. Then I thought about my success rate in the charm department with Nagisa and decided it was best not to risk pissing off the help before they set about determining if I was mortally ill.

Still, I hesitated. Normally, taking off my shirt in front of a stranger wouldn’t bother me at all. I’m relatively fit, and I’d recently shed a lot of American padding. But Japanese men, in addition to being half the size of American men, are essentially hairless. I’m many things, but essentially hairless is not one of them. During my formative growing years, my chest, evidently inspired by repeated viewings of Magnum, P.I., decided that its chief mission in our lifetimes together was to cover itself in thick dark hair, even long after Magnum P.I. vanished from syndication. This it did with an enthusiasm I’ve always wished the uppermost part of my forehead had shared. I’m only grateful my chest never communicated its passion to my back and formed a club.

I don’t want to give the impression that I’m wearing a rug; it’s not that, at least not by ordinary American standards. Some girls there quite like it, in fact. But this wasn’t America. I found myself afraid of seeing in Lucy Liu’s face the kind of reaction my mother had had when my father started describing diseases at the dinner table. If, when I took off my shirt, she turned grey and began rolling her eyes, I was out of there, exam or no exam.

Lucy, bless her, somehow managed to pretend not to be revolted at the fleece on my front. After arranging me and my arms in a series of awkward poses for a battery of chest x-rays, she fiddled over a machine in the corner and removed the results one by one, jamming each x-ray into the top of the light board with a plastic snap. She glanced over each, all the while deftly blocking my view of them with her body, which must be a skill they teach in nurse school. She then gathered the photos into a big translucent pile and rushed them off to a destination somewhere beyond the exam room. As she left, I searched her face for a clue to my fate. Was she bewildered? Horrified? Crestfallen? It was no good. Lucy was a blank page. I was suddenly very glad I hadn’t suggested she take her shirt off.

When she returned a few minutes later, she was all business, her slightly-crossed eyes still as unreadable as a broken clock. She had me lie down on a bed next to what was apparently an electrocardiograph machine. If you’ve ever seen one of these machines, you’d recognize it right off. This one, like most, looked like an earthquake seismograph that had eight or so white plastic suction cups attached to it by wires, just like the kind that used to come attached to the ends of arrows in cowboy-and-indian toy sets. These suction cups adhere wonderfully to 10-year-old foreheads, necks and arms, and also presumably to Japanese men’s torsos. But in the presence of a thick weave of hair that dates back to Tom Sellick’s heyday, they are confounded, useless as chopsticks to a bowling ball.

Lucy Liu had her work cut out for her. She tried gamely to attach all of the white plastic suction cups to my chest. But it was her two hands against the eight of them and my chest hair, and she quickly found herself outmatched. She could get no more than half of the cups attached before the other half began peeling away, tipping over, and falling off. While she struggled with this numerical disadvantage, she also had to operate the machine, which was chugging away during all of this, its little metal arms sweeping back and forth in a mechanical approximation of my heart’s condition. I quickly realized the machine was, at any given moment, operating on only half the information available to it. I began helping Lucy replace wayward suction cups, which meant that I had to lift my torso slightly to see what I was doing, and so it became something of a physical workout, like doing crunches and typing at the same time. I could literally hear the metal arms of the machine moving faster and faster as I did this.

Unperturbed, Lucy continued replacing suction cups and fiddling with the machine until she seemed satisfied. “Hai,” she finally said, which is the Japanese word for “yes” but in practice can mean just about anything in the language except for “no” and in this case meant “we’re all done here.” Convinced that the image the machine now had of my heart must have resembled that of a wild boar with a serious cholesterol problem, I rose and pulled on my shirt, preparing myself for a diagnosis that I should be carved into chops and sold at market as soon as possible.

But Lucy smiled at me, a real smile, and motioned for me to follow her. She led me back out to the lobby, where the three women were waiting and Hiro seemed actually to be increasing his energy and momentum in flagrant disregard of the laws of Newtonian physics.

They formed a huddle around me, full of quiet reassurance. Again I was bewildered by the genuineness of their concern. Who was I to them? They clucked and cooed, stroking my hands, making small talk. If I’d been in America, I might have expected this from family members or very good friends, but from strangers and work associates I saw for maybe two hours a day? It seemed ridiculous. Yet I’d found this kind of kindness everywhere I’d gone in Japan.

In downtown Kanazawa late one night shortly after I’d arrived in the country, I’d boarded the last bus for the train station, meaning to return to Fukui on a red-eye that left in an hour. Thirty minutes later, it had dawned on me that I’d hopped the wrong bus when I found myself deep in the suburbs outside Kanazawa, the sole remaining passenger, miles from the train station. The driver had pulled over, turned off the ignition, removed his hat and looked back at me. “Last stop,” he’d said in broken English.

Five minutes later, he’d nodded and smiled, motioning for me to take my seat again. He’d replaced his hat, started the bus, and then driven me – alone in the bus – all the way to the station without a single stop, charging me nothing for the 45 minutes of his evening he’d devoted to chauffeuring me around his city. And only two words of intelligible English had passed between us.

In Nagano on another late evening, I’d spent an hour searching for a remarkably well-hidden youth hostel on the outskirts of the city, tired and frustrated at having wandered through an ancient residential neighborhood for what felt like an eternity. Finally, I decided to ask for help from a woman who’d stepped out onto the stone stoop of a home in which there seemed to be a small gathering of some sort going on.

“The Zenkoji Kyojuin hostel?” she’d replied in very good English. “Yes, it’s right there.” She’d pointed directly across the street from where we were standing at a wooden wall. Naturally, there was the international sign for “youth hostel,” right at eye level. The gate was closed and locked, however. “I’ll speak to them,” she’d said. She pressed the buzzer and had a brief exchange in Japanese with someone on the other end. “They’re full, I’m sorry. That is why the gate is locked. There are no beds.” Crushed, I’d wilted like wet paper. “I know another hotel nearby,” she said, “please wait.”

She’d spent the next 20 minutes standing in the street with me, calling a series of hotels on her cellphone. People came and went from the house, and at one point a man joined us, her older brother, who smiled and smoked and wrote down phone numbers and addresses on a piece of paper for me. When she’d finally arranged a reservation for me at a cheap hotel not far from us, me with a map and addresses in hand, I’d thanked them both profusely.

“What is the party for?” I’d asked, gesturing toward the house.

“It’s for our father,” she’d said. “He died this morning.”


Lucy Liu came for me again after a short wait, and she led all of us into a small office near the examination room. There, an elderly Japanese gentleman in a doctor’s coat was peering at the x-ray images of my chest on a light board. It was crowded in the room with all of us packed in it – me, him, Miwako, Hiro, Kaori, Nagisa, and Lucy Liu. He gestured for me to sit down. So that’s how it’s going to be, I thought. Sitting-down news. I couldn’t pretend to be surprised.

The doctor began speaking to me in Japanese, but once he realized that every word was going right past me, he turned his head and began speaking to Nagisa. This went on for some time, punctuated by him pointing at specific regions of my chest on the x-rays, and every so often he’d point at a spot on my own chest as if in explanation. He spoke without pause, at one point motioning for me to remove my shirt, which I did like a zombie, and at another point taking my blood pressure while he continued to speak to Nagisa and the assembled entourage, who stood listening in complete silence. Finally, he stopped, and looked at me. Everybody looked at me. Even Hiro had come to a halt, momentarily still as stone. Nagisa opened her mouth to speak.

“He says there’s nothing wrong with you. You’re fine.”

I was stunned, literally speechless. Everybody was smiling.

“That’s it?” I finally managed. “That’s all he said?”

Nagisa kneeled in front of me, suddenly very serious. She took one of my hands in hers and looked me in the eyes. “Are you feeling anxious about anything?”