Demonstration going on in Beijing, says the Nikkei:

A demonstration was being held on the morning of 9 April in the western part of Beijing to call for boycotts of Japanese goods. The reasons given were opposition to Japan’s possible permanent membership in the UN Security Council and dissatisfaction with Japan’s history textbook approval system. Participants numbered in the several thousands, many of whom were shouting their criticisms. The organizers, who had called for participants over the Internet, had predicted that between 10,000 and 20,000 people would gather.

Protesters have also named a disputed island chain–there are a lot of them in Asia–as an irritant. The area in which the demonstration is being conducted has a lot of places that deal in Japanese electronics.



It’s up on Reuters, also.



Added on 11 April: Simon, naturally, has a whole lot of links about the demonstrations, which were held across China. I was going to update this post, but he and his folks have pretty much got it covered.

Ah, socialized medicine. No one gets extravagant care, no one gets inadequate care–we all get good, solid, top-of-the-line care delivered as cost-effectively as possible.

Except when we don’t:

The deaths of four patients at Tokyo Medical University Hospital as a result of coronary artery bypass operations performed by one of its surgeons has highlighted the fact that the hospital failed to properly operate a system under which the surgeon’s skills could improve.

An external committee investigating the hospital on suspicion of malpractice pointed this out at a press conference on March 30 in Tokyo following its probe of the hospital’s second surgery department, to which the 45-year-old surgeon belonged.

The independent committee was established in December and comprises five heart surgeons from outside the hospital.

One of the committee members said at the press conference: “The surgeon was unskilled. He hadn’t acquired the basic knowledge required for heart surgery.”

Do be sure to click on the link and keep reading–it gets worse from there. Bear in mind that Tokyo Medical University Hospital is not some little backwater institution, either. And heart surgery, in a first-world population that is rapidly aging, is not an obscure little specialty. And screw-ups in the health-care system have been news for at least the near-decade I’ve been here.

Of course, Japan’s nationwide certification systems–not just those of the hospital–may need review:

Japan has about 260,000 doctors, but there are about 300,000 specialists as some doctors hold more than one specialization, an indication of how easy they are to get.

I don’t really know what to make of this–maybe the US is as bad. I’d have no trouble believing that it isn’t, though. The Japanese, in all fields, love certifying boards, but that doesn’t necessarily mean high standards are consistently maintained.

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In related news, a committee of the Japan Society of Intensive Care Medicine has proposed guidelines for treatment cessation–again, a very sticky issue in an aging society (English version, which differs in small points from my translation, here):

The committee proposed strict conditions as grounds for cessation of treatment: (1) multiple doctors have administered the highest-level of treatments currently available [for the patient’s illness], (2) the medical facility has informed the family that it has the option to seek a second medical opinion from a different hospital, (3) doctors with the fullest available experience and specialized knowledge have confirmed repeatedly that it is impossible to save the patient.

In addition, the proposal establishes four options that a medical facility must offer to the family [of a patient whose case meets the above conditions]: (1) intensifying of treatment, (2) maintenance of the current course of treatments, (3) decrease in amount of medication or treatment, or (4) cessation of treatment. However, in the case that cessation of treatment is chosen, it is forbidden to detach the patient from an artificial respirator, oxygen supply, or minimal supply of water and nutrients.

Mercy-killing is an issue that’s started to bubble through the Japanese medical system, erupting most recently in the conviction of a Kawasaki doctor for murder:

Suda has insisted that she removed the tube and instructed the nurse to give him muscle relaxant without attaching a respirator in a bid to help him die in a natural way at the request of his family in November 1998.

…

Presiding Judge Kenji Hirose denied her claims.

“There was a possibility of recovery. The court doesn’t find that she provided the best treatment,” the judge said.

As for Suda’s claims that the patent’s family approved of her actions to help him die naturally, Hirose said that the doctor misunderstood the family’s mindset.

As reasons for suspending the sentence, Hirose said that Suda tried to help the patient die naturally for the sake of his family although she misunderstood his family’s sentiment at that time.

In this case, the tragedy was pretty clearly a misunderstanding. The patient was comatose; the prosecution acknowledged that he was expected to live only a few weeks. The doctor claimed that she had given him not a lethal dose of muscle relaxant but just enough to try to keep his airway open after the tube was removed. I’ve seen no medical evidence to prove or disprove that; if it existed, I think it would have come out in the two or three years the case has been around.

However, health care costs are skyrocketing in Japan, for obvious reasons. For now, Social Insurance still makes it possible for the four options enumerated above to be equally feasible, I think, for most people. It’s not hard to imagine that triage-minded doctors, constrained by funding and resource shortages, will in the not-too-distant future gradually begin more frequently urging family members to approve cessation of drug and surgical treatments, with only nourishment provided.

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I know that American readers will be reminded of a recent, similar (thought not entirely parallel) case in our own country. I haven’t said a public word about that case in two years, and I’m not going to make it a topic here, because I’ve found that no one on either side of the debate has been able to do so without speculation about who really loves and understands whom, within a family most of us don’t know at all. So if anyone is inclined to comment, be it known that any comment mentioning that case explicitly will be deleted. I don’t care whom it’s from.

Two announcements:

1. My old e-mail address doesn’t work anymore, but you can e-mail me at skinsell[at]gmail[dot]com. I have not been trying to keep my contact information a secret; if you use the contact page at left, it sends a message to my gmail account with the address you enter as the reply-to, so I just figured people would figure it out. I guess it’s not as obvious as I thought. Sorry about that. You don’t have to look for a comment by me somewhere and lift the address from there.

2. Some of you could stand to learn how easy it is not to read a website. You just kind of…don’t click on it, you know? If you want a website that’s more gay, less gay, more Japan-focused, less Japan-focused, gay but without the jokey pop-culture stuff, nicer, nastier, more concise, lefter, righter, libertarianer, or not as pink and purple, by all means (1) find it and (2) read it instead of me. See? Easy.

   I’m not trying to avoid criticism or counter-arguments, and I’ve been known to respond favorably to requests that I comment on something I hadn’t myself thought to address, if the subject interested me. I’ve received only two messages ever that I’d call hate mail, and only a handful more that I’d consider obnoxious about making an actual point; my mail volume is relatively small, but most of it is above-average in level of civility.

   I’m grateful for that, just as I’m grateful for those who read this site without commenting. Nevertheless, even if the tone is friendly, I don’t see the purpose of messages that are the on-line equivalent of “You know, you’d be really cute if you were blond.” Okay, so…no hard feelings, and good luck scamming on Brad Pitt over there. You can’t please everybody, and I’m not interested in learning how I could if I were a different person.

This AP story about a gay soldier who would like to continue serving after recovering from his wounds is making the rounds; it was Gay News where I first saw it.

Out of all the sticking points over gays, I have to say, this is one of those I understand the least. The Center for Military Readiness, whose president is quoted in the AP article, has a full page of links on gays in the military, including one to the exclusion law. But the actual nuts-and-bolts reasoning given for the exclusion is very thin. It’s self-evident that the armed forces should only train those elibigle for service, but eligible is one of those words like efficient or positive; it only means something if we all agree on the criteria by which it’s being applied to a given case.

The CMR releases and the text of Public Law 103-160, Section 654, Title 10 refer to the fact that the armed forces are a special environment requiring unusual discipline, close quartering, little privacy, and unit cohesion. That having gays around would compromise these things is an assumption–it’s not even really asserted, much less justified. I understand the value of tradition, and I know it’s been found that military service is not a constitutional right.

But you’d think that the reasons for declaring people unfit (that “ineligible” bit is a PC euphemism worthy of the English department at Duke, and it conveniently avoids the question of whether people such as the discharged linguists were more qualified for their jobs than others who might have been trained for them) would be less vague. Given that “Don’t ask, don’t tell” has been in effect for a decade, if homosexuals were going to throw a wrench into the works, wouldn’t we know it by now? Not having two gay guys serving in the same unit makes sense–family members are separated, too, unless they’ve done away with that rule.

But a lot of opposition, when you press people to be clear about what it is they’re so afraid of, comes down, in my experience, to the old shower-room argument. And try as I might, I can’t find it in me to take the whole “Well, see, I’m such a tough guy that I’m obliged to get spazzy if I think some gay guy just looked at me cross-eyed” routine seriously.

In any case, Sgt. Stout was wounded while operating a gun, so whether or not he has any influence on policy, he did his job defending his unit and at least serves as an example that all gay guys don’t compulsively flee physical conflict. I’m grateful for his service, and here’s hoping he’s recovered fully. (I’m assuming so, but the article doesn’t say.)


Added during a particularly overdone episode of Homicide : Apparently, Michael’s trackbacks are not, in fact, getting through. Here is where his response, in addition to his comments here, is.

Riding Sun seems like a good guy, but he and a few of his commenters have an all-too-common reaction to one of the irritations of living in Japan:

So, over time, I’ve developed a standard response I use whenever someone comments favorably about my ability to use chopsticks:

Why, thank you for noticing my chopstick technique! It didn’t come easy, let me tell you. I studied under a chopstick sensei every day for five years. My father took a second job to pay for the lessons. I even withdrew from school at one point to devote myself full-time to chopstick mastery. Long into the night, I would practice picking up dried peas until my fingers ached…

I carry on in that vein until the other person realizes I’m being sarcastic. It usually takes longer than you’d think.

Personally, I find that the reply “Well, you know, it’s like everything else–it just takes a little practice” works better than sarcasm. If you’re with people you know from work, you can deliver it with that cringey little bow you give when being complimented, to convey gratitude along with the gentle message “Japanese language and forms are learnable skills if you apply yourself; they’re not as hocus-pocusy as you may think.” If you’re with your new landlord, you can deliver it with an extra-respectful cringe to convey, “I’ll be sure to learn which garbage goes out which night so you’ll never see bags sitting there for days.” If you’re with a guy who’s flirting with you, you can deliver it with The Look to convey, “I’m an all-around quick study, baby.”

The problem with sarcasm in these situations is twofold. For one thing, it’s a no-no in formal Japanese interaction with near-strangers, so using it kind of casts doubt on the idea that you understand the culture here more than your interlocutor thinks you do. (If Japanese people seem not to be picking up on it, it may be that they’re laboring to give you the benefit of the doubt rather than just leaping to the obvious conclusion that you’re being ungentlemanly.) For another, sarcasm deflects goodwill. Yes, it’s trying to be constantly informed how especially special Japan is. But when people compliment your ability to do Japanese things, they’re saying, “I’m proud of my heritage, and I’m honored that you’re learning to navigate it.” What’s the harm in acknowledging that and letting it drop?

The Yomiuri has taken a poll and found that 61% of respondents (all eligible voters) favor revision of the constitution–mostly centered around Article 9. (Thinner English version here.) More than half of those who agreed the constitution should be revised stated (or chose from a list–it doesn’t say), “New problems have arisen in the world that the existing constitution cannot address.” That included privacy and environmental issues as well as Japan’s role in world peace. The percent of DPJ supporters who endorsed constitutional revision (67%) was actually higher than that of LDP supporters (64%). Even when the issue of Article 9 was broken out, LDP (50%) and DPJ (49%) supporters were nearly even.

The editorial in this morning’s Nikkei was about Japan Post reform and addresses several sticking points:

Prior [to the release of the plan] the LDP compiled a document called “Modes of Thinking for Japan Post Reform.” In it, there were several problems with the government’s proposal indicated, including (1) the corporation that will be financed by the government will be state-owned and privately-managed, and so there are fears that its projects will fall prey to corruption, (2) the division of Japan Post into four companies simply increases the number of positions available for 天下り (amakudari: lit., “descent from the heavens”), (3) it has not been proven that the four new companies (posts, savings accounts, insurance, and counter services) will really be independent.

Amakudari is similar to what we’d call a revolving door: the system in which high government officials retire to semi-public management or “consulting” jobs in which they can use their accumulated connections and influence to manage resources. Civil servants make less than they could with equivalent credentials in the private sector because the assumption that they’ll retire in their mid-50s and take more-lucrative jobs related to their fields. Government officials have complained about attempts to reform the system because–and it’s hard not to sympathize with them to some degree–they’ve all gone through their entire careers with the understanding that things would work this way. On the other hand, the number of redundant positions boggles the imagination, and attempts at reform are seen as suspect by the Japanese people.

I normally don’t talk this way, but…

Man, I’m old.

Look at this:

My partner of 12 years, Alison Maddex, gave birth to a baby boy in November 2002 — Lucien Harry Maddex. I am Lucien’s adoptive parent — but certainly NOT his mother! Alison is Lucien’s one and only mother. That “Heather Has Two Mommies” business gives me the creeps! — and it can only confuse a kid.

12 years?! Oy. I remember when that relationship was all rumor–Paglia’s a local celeb in Philadelphia, and I was in college at the time.

Of course, she talks about a bunch of things: the absence of poets from the pop-culture landscape and the limitations of blogging in helping people develop as writers among them.

Watch yourself, Amritas. Not even a dear buddy like you is going to get away with sideswiping Kylie. I know an insinuation when I see one. (Additionally, the idea of a straight guy who’s so busy looking at pious plucked chickens like Brad Pitt and Bono that he doesn’t notice Kylie on-stage is frying my brain serious-big-time. 😉 ) Whether she understands free markets in general as well as she knows how to market herself, I do not know; on the evidence of this particular charity she supports, probably not. But, you know, I’ve been a Madonna fan for twenty years. I’m used to adoring a diva’s music and videos while simultaneously wishing she’d stop offering opinions about what life must be like for anyone with a fortune of less than US$200 million.

Speaking of Kylie…well, we’ll get back to Kylie. I’ll start by saying that, if you’re looking for a song to escape into through your headphones while on an inbound Tokyo commuter train at 8:30 a.m., “Rush Hour” by Jane Wiedlin is a very bad choice. Yeah, I know–the lyrics are metaphorical. Somehow, “Feel it gettin’ hot in here / Feel me gettin’ close to you, dear” does not feel metaphorical when it’s one of the first warm mornings of spring and you’re jammed against a middle-aged salaryman who clearly took his last cigarette puff immediately before boarding. I tried closing my eyes and picturing the video, which was all zooming dolphins and stuff, but it didn’t work.

Oh, yeah, and while I’m on the subject of Jane: Yoo-hoo! Mr. Three-Word-Dismissal? Vacation did not suck. NOT. Five of the songs sucked, but that’s out of twelve. It’s worth it for “Worlds Away” alone, one of the best songs to take a solitary bath to ever.

Now, Kylie, she’s got some good bathtub songs, but her single from a few months ago, “I Believe in You“? Perfection as a crowded-train song. You could say to yourself, “I’m not actually being crushed to death by enough people to staff an oil tanker squeezed into a space the size of my entryway. I’m standing alone in a cage of abstract neon tubing, with such a lot of invitingly cool, dark space around me, singing devotional lyrics and making climbing-ivy hand gestures of serene ecstasy.” It just took one jab from an umbrella to bring you out of it, but it was a nice place to float off to.

It’s touching that Dean has the patience to keep coming up with new anagrams of his position on gay marriage, as if one day one of his gay friends might listen. But then, as someone’s bound to point out, I’m sitting here writing this post, so who am I to talk?

Anyway, one thing he’s going off about in the comments is the epidemic of revisionist history among quite a few SSM advocates. I think it’s worth expanding backward on that point a little.

People used not to understand fertility. I don’t just mean human fertility–they didn’t understand why crops grew and hunt animals were plentiful sometimes but not others, either, any more than they understood why sex sometimes produced children and other times didn’t. Further, the competition for precious resources was fierce. Even after the invention of cavalry and chariots and catapults and cauldrons of pitch, war essentially meant hand-to-hand combat; and there was a lot of war. There was also a lot of disease.



What all this boiled down to was that human societies knew they desperately needed to keep replacing themselves and the things they subsisted on, but they were never quite sure what was going to work. Things like nitrogen-based fertilizer, filmstrips of sperm and ovum meeting under a microscope, and mechanical refrigeration are all very, very new in human history.

You already know this, so why am I bringing it up? Because I think it’s easy to forget how the pressure to ensure fertility at all costs has shaped civilization. (Well, Japan, with its disorienting blend of super-modernity and raw primalness, has not lost a lot of its old rites.) When people oppose gay marriage because they assume there’s no love or commitment in our relationships, they’re being ignorant and need to be told so. Even in old times, there were people who reproduced and people who didn’t. There’s no reason gay people can’t contribute to civilization just because we’re not contributing children, and having two people willingly take stewardship over each other’s welfare has obvious benefits.

But you can argue that, and argue that our ability to care for each other needs protecting in a world of competing interests, without necessarily concluding that marriage has to be expanded to do it. The ability to choose your own life partner is a pretty new thing. Maybe it needs a new institution. Maybe it would do better without any overarching institution but a range of contract options. Maybe, maybe, maybe. The point is, the debate is still going on, and not even all of us who are gay can agree that SSM should be legalized or why. Its advocates are not doing themselves any favors by acting as if the correct conclusion were obvious to, like, any fair-minded person with a brain.