[I am writing this after the journal entries for the week of 7/3. The information is being taken from notes. I put off writing this a little longer than I expected due to the trip to Tokyo. I hope this eases any confusion.] I had a major event on Saturday, July 1. I made an attempt to climb Mt. Fuji. I thought this would be fairly easy and treated the event rather lightly. The night before, a small group of people went out for yakitori and drinks. The yakitori is skewered meat and vegetables. Kamogawa has an excellent yakitori shop with a wide variety of choices. Mostly, we ate chicken and fish. It was the second time I had been there and it was as good as it was the first time. Much beer was also consumed, along with a Cuban cigar. I am not a big cigar smoker and do not smoke cigarettes, so this was a rare event. It was the second cigar I had ever smoked. Alas, a Cuban cigar is one of those things you cannot pass up. The evening ended relatively early and I retired to prepare for Fuji, early the following morning. I was to go up Fuji with the Swansons, a family whose patriarch is the Director of Medical Education at Kameda. The family consists of Todd (Director of Med Ed), Eileen (his wife), Matt (15 years old), Isaac (13), and Sam (10). I arrived at their house at 7:45 AM. They were a little slower in getting started than I was, since Wimbleton was on the night before. The matches START at 11:00 PM here and go through the night. I can understand why they were a little tired. Just prior to 9:00, we set out. The drive to Fuji was around 4 hours. It went by fairly quickly with a variety of good conversations. The Swanson kids are really sharp and are very mature and polite--a real pleasure to deal with. When people climb Fuji, there are several possible approaches to it. You can approach from two different sides of the mountain. You also have the option to start from the base or from Station 5. Station 5 is about half-way up the mountain (or 6000 feet of the 12,387 foot mountain). Most people choose to start from Station 5, and our group was no exception. I knew immediately upon getting out of the car, that I was in trouble. Though I had barely moved, I could feel the difference in the oxygen content of the air. We had very little time to acclimate to the altitude before climbing. By about 1:30, we started our ascent. The mountain is composed of volcanic stones. This is a difficult surface to walk on, but when you ascend at a sharp angle, it is even more difficult. My legs remained strong, but the altitude proved to be extremely trying. Spending your life in the flat midwest and the last month at sea level is probably not the best training for this. As we ascended, the group separated. Matt went far ahead of the others, largely the product of living in Boise and regularly climbing mountains. Sam and Todd were the next group. I climbed with Eileen and Isaac. The last two groups were not far apart. We rested frequently, but with the altitude, it was difficult to recover quickly and carry on. The pattern up the mountain was: climb, rest, climb, rest, look how far I had come, take a picture, look how far I had to go, climb, rest. The altitude problems, of course, got worse as we continued. The air got thinner and rest was needed more frequently. We eventually made it up to around the 11,000 foot level. Nearly four and a half hours passed from the start to end of my ascent. Todd and Matt decided to continue on to the summit. I chose to stop. The altitude was completely killing me. I rested for a while and began to make my way down. I partnered with Sam (the 10 year old) and began to make my way down. My objective to prove to myself that the altitude coupled with the angle was my enemy on the way up. The way down requires a lot of care to assure that you do not injure your ankles and knees. With my objective of proving myself, I chose to climb with Sam. Young kids don't have the concerns that others have about damaging their knees and ankles. I knew he would essentially run down the plane of volcanic rock. We made it down to the bottom in under an hour and a half. We slid and slipped much of the way down, but managed to avoid any major problems. The pace we kept and the approach we used to get down made me feel that I had redeemed myself from the shaky climb. During the ascent and descent, I noticed that we were moving much quicker than many other groups on the mountain. I learned later that the recommended time to climb the mountain was seven hours. The recommended time to get down is 3-4 hours. It seems we pushed a little too hard on the journey up. Consequently, I don't feel too bad about not making it all the way up. Every step I took required a lot of willpower. I set and surpassed several goals that day. The summit remained out of reach, but I feel that I accomplished more than I thought possible when I found how crippling the altitude was. All in all, it was a very positive experience, though I can say that I would never do it again. I bought a couple of trinkets at the Station 5 store before leaving. I slept like a baby that night. I was also pleased to see how sunburned I was the next morning. I was truly an Iowa redneck... There was a lot more seismic activity here in the last few days. Miyake (unsure of spelling) Island had a lava flow going underneath it. Areas nearby, like Kamogawa, had constant tremors. There were some significant earthquakes and many small ones. The island was evacuated. People were allowed to return to the island after some scientists declared it safe to return, that the risk of eruption had completely passed. On July 8th, a mountain on the island spit tons of ash into the sky. I guess the scientists were wrong. No word yet on the results of the eruption. Hospital administration section follows: On Monday, the 26th, I visited the human resources/personnel department of Kameda. They handle the pensions, hiring, and other HR matters. They do almost nothing with training. There are also very limited efforts to establish any hospital rules with new employees. In addition, when a person is hired, they never perform background checks or check references. They base their decisions to hire on flimsy claims from the job applicants. I also found that the handling of pension funds is a fairly easy part of the HR department's job. Investing pension money is ILLEGAL in Japan. Since the current interest rate in Japan is near zero, pension funds earn ZERO RETURN. I even had a difficult time asking the question, since the idea of investing these funds is completely alien to the Japanese. Interesting... On Tuesday, I visited the Billing Department of the hospital. I was led through a messy office into a back room filled with boxes. These boxes were filled with the paper forms that the Japanese government requires hospitals to file for reimbursement. The fact that you are UNABLE to file billing electronically seems very backward to me. Other areas were also surprising. The cashiers were using old-fashioned calculators to figure co-payments. No computers to be seen at their desks...Strange that a hospital with a world renowned electronic medical record should be using calculators to figure copays. In spite of these shortcomings, the billing department did a good job of assuring that their staff were able to perform any job in the department. This model seemed a good fit for a department that is subject to high turnover. Wednesday, I visited a pair of departments. The facilities division was interesting. They explained that they are forced to remodel, rather than build, since banks cannot loan much. The economy in Japan is in poor condition and has been for a long time. The Kameda Tower project has been on hold for quite some time. The facilities division also was proud of the fact that they generate their own power, though they could tell me very little about it. I also spent some time in Public Relations. They were mostly interested in talking about the United States. During the short time we were on topic, they confirmed that hospitals cannot advertise in Japan. The only mediums they can freely advertise in are pamphlets in the hospital and the internet. The latter is used very little. I attempted to encourage the use of the Internet to get Kameda's name out there more. How large was the PR staff for the 800+ bed hospital? Two. General Affairs was on Thursday. They handle almost every function that doesn't fit well in other areas. Important areas include budgeting and contract making. In Japan, lawyers are almost never used to write contracts. Through a series of questions, I found that Kameda has NEVER been to court on a contract dispute. The budgeting for the hospital was also interesting. The people that write the budget have ZERO accounting experience. That surprised me. General affairs also is in charge of the secretaries in the hospital. I learned that this is an easy job, since there are only FIVE of them in the whole place. Almost all of them work in the administrative area. They let slip that they are responsible for disaster planning. I pounced on that one. They have no idea how long they can generate power in the event of a disaster. Tsunami hits: no plan. Airplane crash: no plan. Any disaster: no plan. Hmmm... That's it up to this point. I am making good progress on my projects and hope to get some more work done on them in the next few days...
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