An Act of Self-Care: Visiting the Breast Clinic in Tokyo

The waiting room of the Sakurashinmachi Hamaoka Breast Clinic was definitely designed with the idea of calming down a group of women who are waiting for mammograms and other unpleasantries. Nicely cushioned, comfy chairs were spaced at socially distant intervals, an aroma steam diffuser kept the room pleasantly scented and at a comfortable level of humidity, and tranquil Hawaiian music softly warbled on the stereo.  I was the only foreigner. As I gave the woman at the front desk my insurance card, she began to ask me if this was my first time and if I would like the form in . . . “English!” I quickly interjected. 

Recently, I’d detected a lump in my left breast. I wish I could say that this was because I am a responsible adult and it was during my monthly breast self-examination. The truth is that I was lying awkwardly on the couch, binging Netflix, and as I reached over to grab a snack, my hand brushed my pajama-clad chest and something didn’t feel normal. Upon further investigation, I realized that it was probably the same benign lump I’ve had for a few years (some boobs are just like that, thanks a ton, genetics!) but it felt. . . larger. Firmer. Scarier. Definitely worth checking out.

These kinds of things are always nerve-inducing, and just plain icky. But in a foreign country, with a language barrier? Comic gold.

At the breast clinic, I filled out the form, and sat down with my Kindle to wait. Minutes later my name was called. I was given a pink dressing gown and slippers and shown a locker where I could stow my clothes. After changing, I sat in a long hall, with a row of the cushy chairs, lined up before a few examination rooms and two televisions. 

Televisions are ubiquitous in Japan. I used to think that Americans watched a lot of TV, but I think Japanese people have us beat. However, I don’t know if Japanese people sit down and actively watch TV, as much as just keep it on as background. When I lived in sharehouses, I was surprised by how my Japanese housemates always had the TV on, and usually left it on. In addition, TVs are in every waiting room, and as well as many casual neighborhood bars and restaurants. 

I wasn’t waiting long before I was called in to see the doctor. Miraculously, he spoke perfect English! The clinic did have an English page on their website, but you just never know. We briefly talked about the lump, and then it was time for the examination. 

In doctor’s offices in Japan, they really try to take care of women’s perceived fragile senses of modesty. I went behind a curtain where I undressed, with the nurse holding a towel behind me, like some form of double modesty protection, which she laid on top of me before calling the doctor in. I found this touching, but extremely unnecessary, as the minute the doctor got back there the towel came off so that he could do an ultrasound. 

I’m not particularly squeamish, but I don’t really like to watch medical procedures. My default is to stare straight up at the ceiling, or ahead at the wall, or somewhere that isn’t related to whatever they are doing. But the doctor had me look at the ultrasound monitor while he was doing the examination, and explained everything he was seeing to me. Before this, I don’t know if I had realized how much I’d allowed a subconscious fear over the lump dampen my life, like clouds gathering on the horizon of my mind. Seeing my body in this way and understanding what was going on allowed me to take back some kind of agency. In regards to the lump, he said the color was ok (cancerous lumps usually read darker on the ultrasound) but he didn’t like the shape; it was a little large and irregular. So, he wanted to do both a mammogram and a needle biopsy. My favorite kind of doctor: thorough, informative, but still caring. 

Back out in the waiting hall, I tried to figure out what was going on in the news. Japanese TV programs are always a bit overwhelming. There’s always a ton of text on the screen, which I usually can’t read but find distracting nonetheless. I think the idea is that, even if you can’t hear it, you can see what’s going on. Many talk shows and variety shows are even subtitled throughout, which must be convenient for Japanese learners. The news bulletin seemed to be about Coronavirus, for it had some numbers and the kanji for “human”, which I took to mean the number of new cases, and Tokyo’s Governor Koike was giving some remarks. Because of social distancing, she was talking at a makeshift podium, a table really, with reporters a considerable distance away. On the table, I noticed several microphones and a row of cell phones lined up, recording. It was at this moment that my name was called, and I stepped into the mammogram room. 

Mammogram machines look a little insane, like high-tech torture devices (which, let’s face it, they are.) The tech explained we would do the right breast first. I stepped up to the machine, but this was actually my first mammogram, so I wasn’t sure what I was supposed to do. The poor tech took one look at me and broke out in nervous giggles. Apologizing, she ran over to her computer, where she had a printout of her instructions in English. She ran back over, and began giving me very formal commands as she manipulated my body into the correct position: “Place your right shoulder here. I will lift your breast. I will press your breast.” Locked into place, she took the picture, then ran back to repeat the procedure on the other side. One vertical for each breast, and also one horizontal. A total of four pictures and a lot of discomfort on my part. Halfway through, I noticed she was sweating behind her face shield. I think she was more uncomfortable than I was. 

That done, back into the waiting hall. I watched an advertisement for kiwi fruit in which felted, fake fruit with eyes and mouths swam, danced and sang. There were two kiwis, and when they sang their kiwi fruit jingle at the end, they were joined by a banana, an apple, and an orange. After a tea commercial and an ad for yakiniku sauce, I was called back in by the doctor to do the needle biopsy. 

I’d had a needle biopsy done previously in San Francisco, by a salty old doctor with zero bedside manner, and had left that experience slightly traumatized. This was much easier. The Japanese doctor did what’s known as a fine needle aspiration. Guided by the ultrasound, he stuck a long, thin needle into the lump to get some samples. Once again, he had me watch the ultrasound monitor as he did it. I would be lying if I told you it was painless, but it wasn’t more painful that a getting a shot or a blood draw. Watching the needle enter the lump on the ultrasound monitor at the same time that I felt it happening was surreal, and strangely satisfying. 

After that, the kind nurse bandaged me up. The doctor and I chitchatted a bit, and I learned that he’d spent three years doing oncology in Texas, which explains why his English is so proficient. He informed me that, judging by the mammogram, I did not have cancer, but to come back for the biopsy results. I thanked him, dressed, and made my next appointment at the front desk.

An ultrasound, mammogram, and needle biopsy in less than an hour for $50 under my insurance. Despite the ickiness of the whole thing, and the tenderness that I was feeling from being squished and poked and prodded, I was really impressed with the clinic. It was as good of an experience as it could possibly have been, and I’m happy to have done it. The lingering cloud has finally lifted. 
Stay Safe,

Mo