I am a literary giant in Japan

noon the next day.

Takenaka Hospital, Naniwa-ku, Osaka City, Osaka Prefecture.

The middle-aged doctor in a white coat finished scrubbing with disinfectant, and arrogantly took the towel handed to him by the nurse. After drying his hands, he picked up a cigarette and walked out of the outpatient department.

"Is it really okay to smoke in the hospital?" Kitagawa Hide, who was following closely behind the middle-aged doctor and also wearing a doctor's gown, asked while holding a pen in one hand and a notebook in the other, taking notes.

"Haha, it's lunch time now, it's okay to break the rules a little bit."

The middle-aged doctor led him to the inpatient department, smiling nonchalantly as he walked.
“Teacher Kitagawa, although our Takenaka Hospital is relatively well-known in the Naniwa area, it is definitely not comparable to Osaka University Hospital.

If you hold us to the same standards as Osaka University Hospital, that would be a little embarrassing."

“We don’t expect to be as well-known in the medical community as our colleagues at Osaka University Hospital.

We just want to protect our own piece of land.”

The middle-aged doctor didn't feel that there was anything wrong with his "depressed" remarks, and added another sentence as he walked.

"I see." Kitagawa Hide nodded slightly, without making any further comments. He just recorded it truthfully and continued to follow him.

It was almost one o'clock, but there were still patients who had registered in the morning waiting anxiously in the hospital corridor.

These patients and their families, who looked exhausted and haggard, sat close together on old chairs, waiting in line to see a doctor.

Kitagawa Hide observed that every face here was anxious due to illness, with tired and flustered expressions, and they would glance at each other probingly from time to time.

When the two men walked through the corridor, these people stood up collectively as if by agreement and bowed to them with awe and trust.

At this moment, the middle-aged doctor who was laughing suddenly put away his smile, put out his cigarette, frowned, nodded seriously, and walked away.

“Are medical resources already so tight?”

Having witnessed the difficulties of seeking medical treatment, treatment and hospitalization in his neighboring country, Kitagawa Hide did not expect that similar situations also existed in developed countries.

The Japanese medical community has always enjoyed a good reputation overseas, and Japan's medical environment is often talked about.

After seeing the true appearance of the grassroots hospital at this time, the glamorous filter was instantly broken.

"Yes. Mr. Kitagawa should have heard about our medical field, right?"

When it comes to serious topics, the middle-aged doctor becomes noticeably more serious.

"What do you mean?"

"The number of students admitted to medical universities and major medical departments each year, as well as the Ministry of Health, Labor and Welfare's control over the total number of practicing physicians." The middle-aged doctor said without hesitation.

"Ah, this. I have heard a little about it."

Kitagawa Hide nodded.
"I heard that the Medical Association had a lot of complaints about the Ministry of Health, Labor and Welfare regarding this spring's 'Spring Fight'."

"Yes."

The middle-aged doctor led him through the corridor again and came to the outpatient department.
“The reason why the profession of doctor is so popular among the people is that the nature of the work is linked to life and health, and it is easy for ordinary people to be in awe of it.

First, the job benefits are very good and are at the top of the middle class.

The medical staff who have just joined our Takenaka Hospital can receive a basic annual salary of 400 million yen.

Those initial trainee doctors who graduate from medical colleges or medical schools of universities can be given an annual salary of at least 580 million yen, depending on the department they join.

By the way, I also heard that the first surgical trainee doctors at Osaka University Hospital can get an annual salary of 800 million yen.

This is really exaggerated, he is almost as good as the chief surgeon of my small hospital."

When talking about annual salary, a smile appeared on the middle-aged doctor's face again.

Kitagawa Hiderai had previously conducted a thorough investigation into the salary data for Japanese doctors.

In 1998, the average annual income of Japanese doctors was about 1200 million yen, and the median was about 750 million yen, ranking first among all professions in Japan.

Publishing house editors, who are also considered to be in the first tier of the workplace, have an average annual income of about 640 million yen, and a median of about 475 million yen.

This shows how popular the profession of doctor is and how well it is accepted by society.

"We can get such a high annual salary thanks to the document "Strictly Limiting the Number of Medical Students and Doctors" submitted by the Medical Association to the Ministry of Health, Labor and Welfare in the early 50s."

As one of the vested interests, the middle-aged doctor did not hesitate to praise the foresight of the Japanese Medical Association.

“Because of this important document, the number of medical students graduating and physicians entering the workforce each year is low.

Similarly, those who have passed such rigorous examinations and qualification verifications are, without exception, the best among their peers and extremely outstanding practitioners. ”

"I have heard about the admission requirements of the Medical University and the Medical Department.

The minimum deviation value is nearly 70.

There are very few high school students in Japan who can meet this score requirement, and it is indeed the most difficult major to enter.

By the way, it seems that if you want to study medicine, the tuition fee must be quite high, right?" Kitagawa Hide asked curiously.

"The tuition for a national university's medical school is about 240 million yen a year. For a private university, the minimum tuition for a six-year program is about 2000 million yen, and the highest is estimated to be 5000 million yen."

The middle-aged doctor interjected.

"Hiss——" Kitagawa Hide took a breath of cold air.

1998 million yen in 2000 was an astronomical figure for an ordinary Japanese family.

No wonder it is said that Japan has serious class stratification.

Under this circumstance, even if children from poor families are admitted to medical majors, it is difficult for them to afford such horrific tuition fees.

If things continue like this, young people who will eventually become doctors will basically come from middle-class and upper-class families.

This is equivalent to completely blocking the path to cross-class boundaries.

No wonder officials from the Ministry of Health, Labor and Welfare would rather take such a big risk and propose to expand the enrollment of medical students.

Once the upward channel is completely blocked, the people's counterattack will not be as simple as protesting.

“However, the small number of registered physicians will also lead to a very tight medical resource situation in various places.

Since last year, the Ministry of Health, Labor and Welfare has intended to expand enrollment in medical majors, and has encouraged major hospitals to expand enrollment and staffing, and encouraged the opening of private clinics.

This is understandable, but in the eyes of current doctors, it is tantamount to snatching food from a tiger’s mouth.”

When the middle-aged doctor mentioned the "Spring Fight" in recent years, his expression changed again.

Expanding enrollment and staffing means making existing vested interests give up their profits.

In fact, giving concessions is secondary.

The key point is that over the years, these full-time doctors have worked hard until late at night every day, and have spent a lot of time, energy and money to get their current income and status.

Now a system reform will allow young people in the future to easily enjoy the same treatment they had in the past.

Who can bear this?

The Japanese Medical Association, which represents the interests of the majority of doctors, even put forward the slogan "If the Ministry of Health, Labor and Welfare dares to expand its staffing, all of us doctors will go on strike directly."

Doctors are united in their own interests, and their social influence is so great that the Ministry of Health, Labor and Welfare cannot bear it. The most terrible thing is that once these doctors really start to strike, God knows how many patients will be affected.

Therefore, the expansion of medical staff and enrollment has been shelved until now.

“What a tricky question.”

Hide Kitagawa remembered that this issue was not mentioned in the original version of "White Tower".

Probably in the 60s when the original work was written, this conflict had not yet broken out in Japan, so the original work basically only focused on the medical dispute issue.

This is why he would collect folk songs and learn from them before copying texts.

There is no doubt that the works that were plagiarized are all classics.

But famous works also have the limitations of their times.

If we copy it exactly as it is and give it to today's readers, it will only make them feel a little out of place.

While copying the text, adapting it into works that are suitable for current audiences is one of the things that Hide Kitagawa has always pursued.

The original version of "White Tower" focuses on the conflicts between doctors and patients, but in today's Japan, there are even more serious conflicts within the medical community.

If the original work of Yamazaki Toyoko was copied completely, it would definitely be criticized as a smooth work that avoids the important issues and tries to please both sides at the same time.

Kitagawa Hide thought about it and decided to think carefully about how to incorporate this new content into the novel after returning.

As they chatted, the two of them unknowingly walked out of the outpatient building and came to the open land.

The inpatient department is just across the street, and there is a new sanatorium building under construction next to it.

The middle-aged doctor gave Kitagawa Hide some scientific knowledge.

Takenaka Hospital covers an area of ​​5000 pings and was built in . The old building complex can no longer meet the growing medical needs.

At the beginning of last year, Osaka City approved the expansion project application of Takenaka Hospital, and this new building of the sanatorium is part of the expansion project.

The building, which will be completed in six months, is firmly surrounded by five-story iron frames and steel bars and is currently in the grouting stage.

The eye-catching grouting towers and cranes, cement mixers and winches all made harsh sounds at the same time. From a distance, on the suspended scaffolding that looked like a chessboard, workers wearing yellow safety helmets were busy working.

"Director Kawata! Thank you very much for taking care of our people last time!"

Amid the noisy sound of machines, Kato, the construction site manager in a khaki jacket, ran over, regardless of the sweat seeping through his collar, and hurriedly bowed to the middle-aged doctor.

A week ago, a minor accident occurred at the construction site and a worker injured his ankle. It was only thanks to Director Kawata's help in diagnosis and treatment that he recovered quickly.

"Haha, no, no, it's nothing. It's just a minor tear and bruise. Even without treatment, it will heal on its own in ten days.

How is he now? Should he be fine?"

"Thanks to you, we dealt with it early, and there wasn't even a tetanus team."

Kato continued to bow in thanks. If any worker became ill or disabled, he would be the first person responsible.
"By the way, doctor, will your department move into the new building in the future?"

"Oh, yes. I heard it's in the south corner."

Director Kawata pointed to the construction site ahead.

"That's a great place. The orientation, spaciousness, and ventilation are all excellent!"

"Haha, we in the surgery department work the hardest and have the most patients, so it's only natural that we ask for the best position and equipment."

Director Kawata smiled and nodded.

The 16 clinical departments will divide up this new sanatorium building, and the most spacious and comfortable place on the first floor on the south side has been allocated to the First Surgery Department where he is located.

The next good positions are given to the First Internal Medicine Department, the Second Surgery Department, the Second Internal Medicine Department, Obstetrics and Gynecology Department, etc.

The last few departments ranked last will inevitably move to the dark north side where there is no sunlight all day.

Drawing this bad lot means that the director of this department has little power and no resources in the hospital.

“This is the ‘architectural law of power’ in hospitals. The same is true for the current old building.

The signature First Surgery Department of our Zhuzhong Hospital enjoys the best location and treatment. As for the less important departments in our hospital, such as dentistry and ophthalmology, they are all located in the worst locations.

Those old nurses with sallow complexions and fierce looks will also be given priority in those departments.”

Director Kawata proudly introduced the "unspoken rules" of the hospital to Kitagawa Hide.

"I see." Kitagawa Hide recalled that when he went to see a doctor in his previous life, different hospitals and different departments were indeed located in completely different locations.

I used to think it was randomly assigned or required by architectural design requirements.

It turns out the secret is here!

When I think about it, it seems that this is also true for famous universities like the University of Tokyo.

Well-known departments enjoy the best geographical locations and resources, while unknown departments are huddled in deserted corners and become the abandoned children of the school.

"Teacher Kitagawa, I heard that the title of your new novel is "White Tower", which is indeed in line with the setting of a hospital."

Director Kawada, who has worked at Takenaka Hospital for more than 20 years, praised,

“After graduation, ordinary medical students like us worked as unpaid medical assistants in hospital departments while working for pathology professors to write our doctoral dissertations.

Unpaid assistants, paid assistants, initial trainee doctors, final trainee doctors, certified doctors, medical staff.
Just to climb to the position of director of the surgical department in a small hospital like mine would take more than 20 years.

The towering white tower and the countless people climbing up are a very vivid metaphor! "

“Is there a big difference between you and the surgical professors at Osaka University Hospital and Tokyo University Hospital?”

Kitagawa Hide looked at Director Kawata in confusion.

In Japan, university hospitals generally distinguish doctors according to their positions in the university, while operating hospitals such as Takenaka Hospital distinguish doctors by normal job titles.

In terms of rank and position, the department director in a battalion hospital is equivalent to a full professor in a university affiliated hospital.

But during the communication, when Director Kawata talked about the professor of the university hospital, his eyes were full of awe and fear, and his tone was trembling, as if he was mentioning the big boss.

"Of course!"

Director Kawada nodded seriously, and then made a very serious analogy.
"If those surgical professors are world-class top stars in the football league, then the chief of surgery in a small hospital like mine is not even a professional player!"

Kitagawa Hide was stunned for a moment, chewing on his metaphor carefully, and then was stunned.

Is the gap so big?
This sounds like the difference between Cristiano Ronaldo and Ma Jun.

You ask who Ma Jun is?

He was Kitagawa Hide's high school deskmate in his previous life and the captain of the high school football team.

“I know this may seem exaggerated to outsiders. But this is the reality in Japanese medicine.

If I can work in a university hospital, I don’t mind taking the position of chief surgeon in a small hospital!”

Director Kawata said firmly. (End of this chapter)