December 7th., 1991

“Ohayo!”

I risked a surprise, disarming stealth attack, and was rewarded with smiles, like two explosions of dazzling incandescence radiating across a burnished cityscape.

  “Ohayo gozaimasu!”

Mr and Mrs Ishimoto had sprung to attention and, with the exquisite manners of the Japanese, bowed to me from the waist.  We all wore name badges, even their young child Masami, I, because I was a doctor in hospital, they, because they were part of the Utsunomiya-Manukau Sister-City Friendship Delegation.  Mr Ishimoto intoned my name in a sonorous way, pronouncing it as a true spondee that somehow conjured the image of an electrified fence, and a single peal of solemnity and commemoration.  “Dr Camp Bell.”  He introduced himself and laid a hand across the front of his cotton golfing T-shirt.  “I – Australasian representative – Toyota.”  He spoke in a hoarse whisper.  These words must have been very difficult for him.  I believe he might have practised for hours before a mirror.  I was always a little wary of treating patients in the automobile industry.  They carried with them the “Homo sapiens qua internal combustion engine” metaphor.  It might be, for all I know, useful to think of malfunctioning cars in terms of their anatomy, physiology, and pathology, and one often came across troubleshooting motoring manuals based on medical diagnostic models: engine overheating; differential diagnosis – leaking radiator, broken fan belt, blown cylinder head gasket etc.  But trying to apply the metaphor the other way, to think of the dilapidated tenement of the body as a machine on the blink, was an exercise always fraught with frustration and disappointment.  Very few medical problems, almost none, could be solved by the opening of the bonnet and the turning of a screw.  Most lay people, and indeed quite a few doctors, failed to grasp this mysterious paradox of pathology, that the insult and the body’s response to it were inseparable; that, if you will, the disease and the cure were one and the same.

Mr Ishimoto gestured to the woman and child who stood deferentially a little behind him.  We had filled up the triage cubicle.  “My wife, Akeko.  My daughter, Masami.”  Mrs Ishimoto, carrying a child of about two years, bowed once more, and Masami, straddling her mother’s hip, turned and squinted incuriously at me.  I noticed the right arm hung uselessly.  She was a beautiful child, dark-haired, with perfect white skin, intelligent eyes with the shallow orbits and epicanthic folds of the orient, and a small, rosy mouth.  Mr Ishimoto was, I guessed, about forty, and his wife, as beautiful as the child, was much younger, barely older, it seemed to me, than her daughter.

“Masami she fall,” explained Mr Ishimoto.  “We go now to Hawaii, eh…”  He searched for words.  “Holiday.”  (It sounded exactly like “horrid day”.)  “If arm broken, we go back to Narita.”  He said it with simple stoicism.  They were devoted to the child.  I don’t think I’ve ever seen such delirious, almost hysterical love and devotion lavished on children as I have sometimes seen within East Asian families, the Japanese, the Chinese, Vietnamese, and Cambodian.  I palpated Masami’s right arm all the way down from the shoulder girdle, the clavicle, the acromio-clavicular joint, the gleno-humeral joint, the humerus, the elbow, wrist and hand. She did not hinder me in my examination.  The arm hung, passive.  There was no point-tenderness.  I said, “You know what?  I don’t think you need to cancel your trip.  I believe she has a ‘pulled elbow’”.

“Pulled elbow?” said Mr Ishimoto.

“Did somebody give her arm a pull?”  I demonstrated the action in mid-air.  Mr Ishimoto conversed with his wife in rapid Japanese.

“Is possible, yes.”

I wondered if I could explain in simple English the idea of the radial head coming free of the anular ligament as a result of a traction injury.

“Dislocated?” said Mr Ishimoto.  He was the sort of man who could surprise you with an unusual word.  He had taken his language studies seriously.

I said, “In a way.  I believe I can fix it very easily, by turning Masami’s arm over.  She will cry a little, but then she will be fine.”

Mr Ishimoto nodded.  I gently turned Masami’s forearm into full supination, extended the elbow and exerted a little pressure over the radial head. There was a barely palpable click.

“All done!”

Masami fixed me with an accusatory look, and silently cried huge tears.  I recognised the look, as much surprised as pained, of a child who had never before received a hurt from another human hand.  And her mother wept too.  But five minutes later the arm moved freely and normally, and Masami was once more a happy child.

“She needs plaster, bandage?” enquired Mr Ishimoto.

“No – nothing.  She won’t have any more trouble, as long as you are careful not to pull her by the arms.  I should catch your flight to Waikiki if I were you.”  It had been, after all, an “open the bonnet and turn a screw” job, one of the few occasions when a doctor can look as if he has performed a miracle.  Suddenly the Ishimotos had burst out again into broad smiles and I felt as if I were being showered with the perfumed blossoms of a Honshu spring.  I was deluged with small and gorgeously wrapped presents, produced as if from nowhere, a key-ring in the form of a tiny running shoe, a dangerous looking bamboo implement with a hook designed, I was told, to remove wax from ears, cookies, Japanese style, and a silk scarf, Mr Ishimoto said, “For your wife.”   I was embarrassed by a welter of gifts.  He looked again, with curiosity, at my name badge.

“You not Kiwi.”

“I’m from Scotland.”

“Shotland.  Ah!  Shotland!  Whisky!”  He made the name of my country sound like a celebration of its most famous export.

“Exactly.”

He peered at my name. “James.”  (He said “Jameshu.”)  “This, very difficult, for Japanese.”  He took out a small pocket diary, with a pencil, and rapidly wrote three ideograms in Kanji on the back page.  Masami, now quite relaxed, tried to grasp the pencil.  Mr Ishimoto showed the lettering to his wife, who now laughed uninhibitedly.  He turned back to me, and pointed to the three symbols.

“Your name, in ancient Chinese script.”  He pointed to each symbol in turn.

“Leaf… Seed… Sake.”

“Leaf-Seed. Yes I like that.  It has a strong, Nordic ring to it.”  Mr Ishimoto looked uncomprehending at me and smiled politely.  He produced his card.  It was entirely in vertical Japanese script.  He carefully added his telephone number, and handed it to me.

“I will have a fine view of you, in my mind. Hell! Yes!”  (Had he been attending American conversation classes?)  “When you visit Japan” – he said, “Japang” – “you stay with me, my apartment, in Tokyo.  You be my home-stay guest, yes?”

I said carefully, “That is very kind of you.  If I come to your country, I will certainly remember your invitation.”

“Why you come to New Zealand?”  I recognised the direct invitation to friendship of the Japanese, and the insatiable curiosity, that is the antithesis of inscrutability.

I shrugged.  “I enjoy overseas travel.”  It was I who was proving inscrutable.

“You will return home?”

“Maybe.  Not yet, a while.”  I looked at my watch.  “You’d better get going.  You’ll miss your flight.”

  “Ah so desu ka!”  The Ishimotos rose.  He reiterated.  “You come Japang.  Stay with me.  Thank you very much!”  He extended his hand. “Merry Christmas, Dr Jameshu!”  And, with that, the Ishimotos left for the airport.

It had perhaps been a little early in the month for a Yuletide greeting, and indeed, Mr Ishimoto might well have had another, altogether less happy anniversary in mind that day.  He had put me in mind of a film of a book, starring a very famous British rock singer, and based on a work of Laurens van der Post who had, of course, been a prisoner-of-war under the Japanese.  Some of the film had actually been shot within the quiet cloisters of one of New Zealand’s most prestigious schools, separated from our hospital by a single fairway of the city’s most exclusive golf course.  I never saw the film, but I had read the book.  Its inner core had concerned a man who had sought peace, and redemption, after committing an act of betrayal of a loved one.  He had averted tragedy by confronting people who were in the thrall of something alien, gripped by a force outside of themselves, a power of evil.  He had confronted these people; he had forced upon them an image of their own humanity.  He had succeeded in this trial, but at a terrible price.

“Come on, Leaf-Seed,” said Faith, who happened to be Charge-Nurse that day.  She must have heard the tail end of the consultation.  “They got the Sake bit right anyway.”

I mused, “What an extraordinary day for a Japanese to visit Hawaii.”

“What?”

I attempted a rich, expansive, Franklin D. Roosevelt accent.  “On this day, a day that will live in infamy…”  But Faith only looked at me enquiringly.  And, since Mr Ishimoto had put it into my head, I began to think about the impending Yule. The Ishimotos had brought the Christmas spirit to me early.  Of course it is easy now to say this with hindsight, but I feel sure that I had, from that time, a premonition that this would not be, for me, a normal Christmas.  I had the angst mixed with excitement that might be experienced by a pilot, who leaves his carrier by night, and searches the horizon at dawn, anxiously trying to pick out a scattering of islands.  I waited, with apprehension, for Yule.  It was to be my seventh under an antipodean sun.  But, as ever, when I thought of Christmas, I thought of home.

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