Editorial from Asahi Shimbun
June 7, 2001
Spinal Cord Injuries: Double Misfortune in Japan
Suppose you broke your neck in a traffic or sporting accident. A symposium hosted by the Japan Spinal Cord Foundation revealed that your destiny after the accident would, surprisingly, differ according to countries.
When the spinal cord (a bundle of nerves which run through the spine) is injured, it produces various after-effects. For example, if your neck is injured, you will be unable to move your hands and legs, and, in some cases, you cannot breathe by yourself.
In Japan, defects in medical treatment and welfare adversely affect those most seriously injured patients who need a breathing machine (respirator).
In an emergency, saving the patient’s life is the only concern of the medical staff and they don’t pay attention to rehabilitation, which aims at functional recovery. Rehabilitation at early stages is regarded as an ordinary procedure in Western countries. However, it is not usually considered as such in Japan..
In Japan it is only after about two weeks that rehabilitation starts. A patient who experienced rehabilitation, both in Japan and the United States, said that in the United States patients are trained to recover their lost functions and to increase the activities that they can do by themselves.
With the motto of “Don’t strain yourself”, in Japan, focus is placed only on strengthening uninjured functions, and patients tend to idle away their time when, in fact, their injuries are recoverable. As a result, many patients are forced to become bedridden.
If the hospitalization period is too long and the patient has to leave hospital, it will create a great burden on the family. Fatalities caused by faulty breathing machines are common.
Many people think that they cannot speak after a tube has been put into their throat to connect them to the breathing machine. Actually, they will be able to speak depending on the level of aftercare. In Japan patients who are going to use a respirator for a long period receive the same treatment as emergency patients, and this practice is not questioned by anyone.
Mr. Walt Lawrence (a Canadian who participated in the symposium) broke his neck when he dove into a pool and was paralyzed below the neck some 30 years ago when he was seventeen. At first, he could not breathe by himself but after he received training to be taken off the respirator, it became unnecessary to use the breathing machine during the day.
He went to college in a wheelchair from a rehabilitation facility and he now lives in a country house with his wife and 4-year-old adopted daughter, while receiving support from an attendant of his choice. He has been working for 10 years at a hospital as a counselor for those with spinal cord injuries.
In Canada many seriously injured patients now go to college or work because of the example set by Mr. Lawrence.
Every year about 5,000 people become spinal cord injured in Japan and the cause is traffic accidents in half of the cases. At the symposium, a case was introduced in which the iron rule to immobilize the neck if there is any possibility of broken bones was not followed and thus worsened the trouble while heading for hospital.
A person who was fit and healthy yesterday could become paralyzed today instantly in an accident. This danger could befall anyone.
The spinal cord injured are not the only ones whose recoveries and lives differ greatly depending on how rehabilitation is conducted and how much support they can receive with home nursing.
To recognize the difference between this country and others and to learn what we should learn will be the starting point to improve the medical enviroment.