Food and Hospitals [Funny? Memoirs]

Honestly, there are times when I think I am quite privileged. One reason is that while I eat what I like, I never touch anything that is medically wrong or dangerous. I don't eat junk food, and 99% of my drinks are water. Another reason is that as a foreigner, Japanese common sense is not my common sense, so I seem to say or do unexpected things. (I usually find out later that these things were outside the norm, or I don't even realize it at all.)

I'll post a few things that I thought might be funny (as a fellow patient)😄

Funny episodes related to food

1) Confirming if I can order delivery

While I was 100% convinced that ordering delivery to the hospital was okay, I wanted to confirm with the nurse because I didn't want to be a bother when receiving it.

Me: "Is it okay to order delivery here?"

Nurse in charge: "There is no precedent for that."

Me (genuinely relieved, with a beaming smile): "That's good😄 It's not prohibited then. That's a first😉😄🎶 When and where can I ask them to deliver it? Would it be okay to note the elevator area in front of the medical office as the pickup location?" (I had been getting deliveries there on another floor until yesterday, and I don't think there's any reason why delivery food would be dangerous.)

Nurse: "Uh, eh, ah..." Inarticulate sounds leaked out, and her rather reserved expression shifted from a surprise I'd never seen before to bewilderment and confusion. She seemed to be searching for words...

My inner thoughts... Huh?... What's wrong?
Me: "Oh, if I specify it in the notes, they can come to other places too, and I can call them at a convenient time to a place that isn't a hassle for you😄👍" (I genuinely thought I was being helpful)

Nurse: "We don't know about the hygiene aspect..."

Me: "Ah, indeed, that's true. In this day and age, hygiene is a thing, isn't it."

2) Something that happened when I was scheduled to be discharged the day after next

Me: "I can go to the convenience store, right?"

Nurse: "You have to get confirmation from the doctor."

Me: "Actually, I just went and came back. I've already set a precedent that it's okay, so it's fine😄"

The nurse's expression was incredible.

My inner thoughts... Huh?... What's wrong?... I'm being discharged the day after tomorrow... Surely a convenience store is fine... (I set a precedent that it's okay, so isn't it okay?)

The next morning, the nurse in charge said to me, "If there's an emergency call, if we don't know which ward the patient is from, all departments have to rush out, but if we know who the patient is, we'll fly over there. When you want to go to the convenience store, let us know because we'll go with you."

In my heart... oh, am I still set as having a risk of sudden change...? Wait, discharged the day after tomorrow... and, was it okay to go to the convenience store...? Well, the arrhythmia is... I see... I'm glad I bought two days' worth just in case. I'm being more cautious than I thought...

Me: 'Oh, I see. Yes. Oh, actually, thank you.' (Probably, this is how I responded. I am indeed grateful for their attentive care.)

3) No, it's not prohibited.

Nurse: 'This is prohibited. You cannot eat it without the doctor's permission.'

Me: 'Hmm? It's fine. I will definitely get permission. If the attending physician doesn't give permission, it's because of a misunderstanding of my medical history, medication/treatment details, and their effects. You don't need to worry about it.'

At this time, nothing much happened, and although I'm not sure if they actually got the attending physician's permission, it was decided that I could eat it.

Differences and Changes in Thinking

There were many other things that I was told required the attending physician's permission.

As for me, I should probably just execute things silently without asking about trivial matters one by one. And then, just not mention it. In fact, I suspect many people who are hospitalized and can move freely and go where they want do exactly that.

Perhaps my unnecessary consideration of 'I don't want to make them write an incident report' creates a situation that is difficult for both of us.

If it's something that's actually fine, if someone happens to witness it and asks the attending physician, 'Wait, is this okay?', they would probably just say, 'It's fine.'

The attending physician must be busy, too. Honestly, for a doctor, it might be easier to just prohibit things rather than spend time giving permission for a patient's meals or preferences. That way, nothing strange (dangerous) happens. (Is this the hospital's blanket ban...? Blanket bans might also be influenced by the rising rate of medication use in an aging society. Actually, medically speaking, it only needs to be prohibited while taking specific medications or during specific treatments, so some of these restrictions might not be necessary for everyone.) Conversely, I think it's also valid to have the mindset of, 'It's such a trivial, unimportant thing, why not just give permission?'

As for me, I am confident that if I ask the attending physician after ensuring they understand the reasons (or even just by asking), I will definitely get permission. (Why? Because if I were the attending physician, there would be no essential reason to prohibit it. Or, if I were asked while busy with the chores of a newly admitted patient, I would probably instruct that food, which is not medically urgent, be prohibited for the time being on the day of admission, or at night or in the morning. That is the safest approach. After that, once I have a firm grasp of the treatment history and medical history, if I still remember being asked and am not busy with other important tasks, I would grant permission.)

One more point: in countries other than Japan, these things don't require the permission of the attending physician or the hospital for every little situation. (There might also be a background where ingredients like green juice are not widely distributed or supplement intake rates are not high.) However, basically, meals at in-hospital supermarkets and restaurants are free, and it is common to go whenever you feel like it. (Some people do let someone know when they leave the ward.) In the first place, imposing more restrictions than necessary on food, which is a patient's natural right (and where diversity due to religion, etc., is common), is not recommended as good behavior. There is also a school of thought that says it's okay to be as normal as possible during hospitalization. In some cases, they try to suppress the feeling of an emergency and encourage normal operation. (Strict places are strict.) Bringing in food is also not restricted except in special cases like during a transplant or for a low-protein diet. (Hospital food can even be french fries and a giant cutlet. It's not like the idea is that only hospital food is healthy and safe.) Generally, bringing in food is also prohibited early after solid organ transplantation. However, depending on the patient's condition, there are cases where individual arrangements are made, such as heat-treating it at home, putting it in a jar, and reheating it at the hospital. If an attending physician is asked about a general patient's diet, and they ask, 'Why are you asking that? Is it that dangerous?' and the response is, 'I eat it every day, nothing has ever happened, and it's not contraindicated for treatment,' then... 'Just leave it alone.' It's not something we (doctors and nurses) need to be concerned about. This kind of vibe is expected.

Conversely, there are times when they complain, 'You're in the hospital, why do you have to eat something like that? It's (religious) XX food, right? The hospital isn't a hotel,' but then end up saying, 'It's not a problem, you can eat it,' and give the OK on the spot.

If it's a normal illness or treatment without special circumstances, it's generally okay to act within common sense... Religions and cultures are different for everyone, and my impression is that they basically don't get too involved in other people's private lives.

Walking inside the hospital is a good example. If you walk, everyone has a risk of falling. The older you are, the higher the risk of falling due to various diseases and the decline in physical strength due to age. However, if you stop walking altogether, you will become bedridden due to the hospitalization treatment.

If you are bedridden, there is no risk of falling and no risk of fractures due to falling. However, if you prohibit walking to make the risk of falling 0%, other complications such as the acceleration of dementia due to becoming bedridden will emerge.

It's a question of what is better, isn't it?

If you die in a week or two from a femoral neck fracture after a fall... then is it better to have finished a safe hospitalization by not walking for 10 days, only to become bedridden thereafter, have your dementia accelerate, your QOL hit rock bottom, and the demand for family care and welfare services skyrocket?

What if, when a patient and their family sign a consent form stating, "I will walk at my own risk, and if I fall, break a bone, or develop complications as a result, I will not sue the hospital," the hospital allowed them to walk freely?

Wouldn't it be good if, in the end, the patient's dignity and will were protected even at the cost of personal responsibility, while both the staff and the hospital were also protected?

Depending on how you think about it, what is considered "good behavior" for food and actions might be 180 degrees different.

Outpatient ward? Mall?

In outpatient areas, food carts like those on the Shinkansen sell sandwiches and drinks during lunch hours. It is also common for hospitals to have chapels from the three major religions on-site. Sometimes, the selling point is an atmosphere that doesn't feel like a hospital, similar to a shopping mall.

That said, consent (a WIN-WIN future)

However, well, a peaceful hospital stay where nothing happens is certainly desirable. Furthermore, under recent insurance systems, if the length of stay exceeds a certain point, the hospital's revenue decreases. The more tests and treatments performed, the more the hospital's revenue decreases. Therefore, I can imagine that hospitals also face pressure and disadvantages when patients develop preventable health issues during their stay, leading to increased treatment.

It is also a fact that some people will yell if everything isn't perfect... Well, it is natural that responses differ depending on the region, culture, and climate. Even in Japan, which will become increasingly multinational and multicultural, I want people to know that even if Japanese common sense doesn't apply, it's just a difference in background, and some people are acting with good intentions. If people understand the meaning of the differences and the intent behind the other person's statements (or lack thereof, and their expressions), many will likely adapt. Or perhaps Japan will incorporate different cultures😉

I feel that it is more beneficial for patients and their families not to take their frustrations out on doctors and nurses, not to get angry that they aren't omniscient and don't see everything, and not to get angry unreasonably over accidents that couldn't be prevented (or where restraint or physical confinement would have been necessary to prevent them).

Conclusion reached after various experiences

So, recently, I have come to change my thinking to, "In the first place, if we don't waste time confirming permission, wouldn't it be the case that neither side needs unnecessary interference or permission?" I have started to think, "If you don't make it a topic unnecessarily, and you are convinced it is okay, you should just do it as needed."

If a patient can walk, they go outside the ward during the day and spend their time as they like where staff eyes don't reach. If this is safe, there shouldn't be a need for excessive restrictions. If that's the case, it seems like it would be fine within the ward as well.

If it is a healthy, safe event that doesn't bother those around you, shouldn't you just avoid the trouble of asking staff or taking up their time... one by one?

Previously, I thought, "It's a pity to make them write an incident report, so I'll check and make sure I don't cause any trouble." However, if no one knows about it in the first place, it doesn't become a formal incident. If so, it seems better not to get permission that is lose-lose for nurses, doctors, and patients. Instead, from the time you enter the hospital until you leave, it's best if it doesn't catch anyone's eye or reach anyone's ears. In this regard, it is important to remain silent.

If it doesn't enter as knowledge, it is treated as if it never happened. (If by any chance it was something that shouldn't have been done, then let's honestly correct our actions.)

Well, the hospital might also be grateful not to have to bear the responsibility of interfering with various things.

When something happens, there is no need to immediately erupt like a volcano within the staff or the hospital about "where the responsibility lies" or "how to take responsibility." In the first place, if it is a situation that can happen to anyone who is alive, it is strange to blame someone for a fault that doesn't exist. If the patient doesn't know, they should ask the staff. Just because they are medical professionals doesn't mean they are psychics. It is true that many have sharp observational skills, but if you don't say it in words, no one is watching the actions of one patient out of dozens or thousands all the time. In the first place, even if you were monitoring with a 24-hour camera, it is impossible not to take your eyes off the screen for even a second. First of all, if the patient has a brain to think with, they should use it, tell the staff about themselves, and instead of assuming that all their actions are understood and are okay, they should ask the staff. If the patient doesn't ask and an accident that isn't a mistake occurs, isn't that why we call it an accident? In that regard, while both patients and staff should be relaxed, let's keep the key points in mind so that danger doesn't occur!

Wouldn't that increase everyone's comfort without increasing the staff's workload?

Loosely,

Let's live for today!