Twelve Years Across Borders

Autumn 2020. The cross-border patients had stopped coming and the sun set before I noticed it setting. Japanese labor law required me to keep paying staff at 60 percent of their wages even with no work for them to do. Whether they came in or stayed home, payroll went out. Backed into a corner that was less philosophical than statutory, I started learning Python at a kitchen table in Hakata. This i...

November 2019. A pharmaceutical trader I knew flew to China on business and did not come back — caught what everyone called a bad cold, ended up in a mainland hospital, died there. We sighed at dinner and moved on. I missed the first domino without knowing it was a domino. By April 2020 my office in Hakata was as quiet as an empty classroom, and the work of cross-border medicine had been replaced...

For nearly two years, Hangzhou was two points on a map and the sidewalk between them: a hotel and a twenty-two-floor tower that J Group owned in full, where every desk on every floor drew salary from the same payroll. I rode those elevators twenty times a day. There is a Chinese phrase, xiǎo guǐ nán chán — little devils are hardest to deal with — and the tower was its built form. By summer 2018 I...

A Tuesday in autumn 2017. I had just walked off a flight at Hongqiao Airport in Shanghai when my phone caught signal and my colleague's voice, low and careful, said the words I would replay for years: Lin-san, we have a problem. The university hospital is cancelling Mr. X's admission tomorrow morning. The outpatient doctor had said yes. The senior professor, in the closed meeting, had said no. Thi...

Hangzhou, 2017. A coffee shop two blocks from J Group, where an Americano cost forty-two yuan — about triple what the same cup cost in a Fukuoka convenience store. The location was the point. I came in that morning to meet two people who would, within six weeks, be my business partners. L was a returnee with a thin frame and an address book that mapped the mainland health economy. C was an e-comme...

November 2016. A high wall in the Minato district of Tokyo. Behind it: a Chinese embassy compound, Chinese sovereign territory, where a Taiwanese citizen with no recognized passport could apply for a thin dark-blue travel booklet that the mainland issues to people whose country, from Beijing's point of view, does not exist. The night before I flew to Shanghai, I wrote a will. Nothing dramatic — a...

A business does not fail all at once — it fails the way a tap closes, a quarter turn at a time. By autumn 2015 a competitor had opened up near Kurume and the patients were going to him. For four months my revenue was close to zero. Then a private clinic in Tokyo entered the picture, with a window that framed the orange glow of a city tower at night. And then, on a single phone call in October 2016...

August 2015, Fukuoka Legal Affairs Bureau, ticket number 47. Inside a manila folder on my lap was a name in three characters of black ink — Shingihou — a name my grandfather's rice shop in Yilan had carried through the 1920s and which had waited fifty years to be used again. The visa for a foreign founder in Japan required ¥5 million in paid-up capital. I did not have it. This chapter is about the...

After the first patient died, the phone did not stop. By spring 2015 my number was circulating inside a quiet word-of-mouth network of Taiwanese families whose physicians had told them there is nothing more we can do here. I drove a twenty-year-old Honda kei-car on the expressway to Kurume, and a different stranger sat in the passenger seat each week. Construction bosses, civil servants, men whose...

July 2014. A Wednesday afternoon in a Waseda materials lab on the industrial northern edge of Kyushu. The phone rang with a Taiwan country code. The man on the line said his father had been told there was nothing more to do, that someone had found a cancer vaccine trial at Kurume University, and that the family needed an interpreter. I had never done medical interpretation. I said yes. I needed th...

In 2014, one phone call pulled me from an engineering lab into cross-border medicine. I thought I was helping with one translation; I did not know it would become twelve years. In this episode: medical translation, Japan, Taiwan, and the beginning of cross-border medical coordination. Contact: medicalsupporter.org | shingihou.com | service@shingihou.com ⚠️ Personal reflections only. Not medical pr...