This work is created in collaboration
with International Futures Forum and financed by a grant of the Johnson & Johnson Foundation.
In a bustling clinic in Japan, Dr. Hiroshi Takahashi, a general practitioner, encountered a case that profoundly illustrated the intricacies of patient care in the Japanese healthcare setting. The patient, a middle-aged woman, presented with complaints of chronic pain and sleeplessness. As the consultation progressed, Dr. Takahashi realized that the root of her issues lay in her surroundings and psychological state, rather than purely biomedical factors.
Dr. Takahashi, known for his patient-centered approach, engaged the woman in an alternative dialogue. This method allowed her to articulate her thoughts and feelings more clearly. As she spoke, it became evident to both the doctor and the patient what was truly troubling her and what she needed to address these issues. Dr. Takahashi's strategy was to listen intently and repeatedly ask about her thoughts, focusing on understanding rather than quickly moving to advise or suggest solutions.
This case became a striking example of positive health in practice, demonstrating how a patient can gain clarity and insight into their own needs through deeper exploration of their mind. It highlighted the importance of addressing the more personal and sensitive aspects of health, especially in cases of medically unexplained symptoms (MUS), which are often deeply rooted in an individual's emotional and psychological state.
In the Japanese context, however, such an approach can be challenging due to cultural nuances. The concept of "Honne" and "Tatemae" is particularly significant. "Honne" (本音) refers to one's true feelings and desires, while "Tatemae" (建前) represents the public facade or the socially accepted behavior. Patients, particularly the elderly, often struggle to express their "Honne" to doctors, opting instead for "Tatemae" out of a desire to appear polite and not show weakness.
Recognizing this cultural barrier, Dr. Takahashi saw the necessity of creating an environment where patients felt secure enough to express their "Honne." This was crucial for effective treatment, especially in Japan, where emotional expression is often subdued by societal expectations.
The experience with this patient was an eye-opener for Dr. Takahashi. It reinforced the importance of patient-centered care and the need for healthcare providers to adapt their approach to suit the cultural context of their patients. This case was a testament to the power of empathy and patience in healthcare and left Dr. Takahashi with a deeper understanding of the role of psychology in medicine, particularly in the unique cultural landscape of Japan.